Centers for Disease Control and Prevention Health-Related Quality-of-Life
14-Item Measure
CDC HRQOL-14
"Healthy Days Measure"
Division of Adult and Community Health
National
Center for Chronic Disease Prevention and Health Promotion
The standard 4-item set of Healthy Days core questions (CDC HRQOL-4)
has been in the State-based Behavioral Risk Factor Surveillance System (BRFSS)
since 1993 (see BRFSS Website http://www.cdc.gov/brfss). Since 2000, the
CDC HRQOL-4 has been in the National Health and Nutrition Examination Survey (NHANES)
for persons aged 12 and older. Since 2003, the CDC HRQOL-4 has been in the
Medicare Health Outcome Survey (HOS)—a NCQA HEDIS measure. Standard Activity
Limitation and Healthy Days Symptoms modules have also been available since
January 1995. When used together, these measures comprise the full CDC
HRQOL-14 Measure.
Healthy Days Core Module (CDC HRQOL-4)
1. Would you say that in general your health is:
|
Please Read |
a. Excellent |
1 |
b. Very good |
2 |
c. Good |
3 |
d. Fair |
4 |
or |
e. Poor |
5 |
|
Do not read these responses |
Don't know/Not sure |
7 |
Refused |
9 |
2. Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good?
|
a. Number of Days |
_ _ |
b. None |
8 8 |
|
Don't know/Not sure |
7 7 |
Refused |
9 9 |
3. Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 30 days was your mental health not good?
|
a. Number of Days |
_ _ |
|
b. None |
8 8 |
If both Q2 AND Q3 ="None", skip next question |
|
Don't know/Not sure |
7 7 |
Refused |
9 9 |
4. During the past 30 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation?
|
a. Number of Days |
_ _ |
b. None |
8 8 |
|
Don't know/Not sure |
7 7 |
Refused |
9 9 |
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