MEPS-MPC-Sep. Billing Doctors

SBD Cover Sheet.pdf

Medical Expenditure Panel Survey Household Component and Medical Provider Component (MEPS-HC and MEPS-MPC through 2009)

MEPS-MPC-Sep. Billing Doctors

OMB: 0935-0118

Document [pdf]
Download: pdf | pdf
Provider Probes (PP) Section
Beta

BOX_01A
THE PROVIDER PROBES (PP) SECTION (INCLUDING THE EVENT ROSTER (EV) AND
PROVIDER ROSTER (PV) SECTIONS WHICH ARE CALLED IN THE COURSE OF PP)
COLLECTS THE INFORMATION REQUIRED TO CREATE AN EVENT. THIS INFORMATION
INCLUDES THE EVENT TYPE, PERSON, PROVIDER, AND DATE OR DATE RANGE. ONCE
THE EV SECTION IS COMPLETED FOR AN EVENT, THE INTERVIEWER CANNOT BACK UP
TO EDIT THAT EVENT OR ANY OTHER EVENTS THAT WERE CREATED PREVIOUSLY.
HOWEVER, EVENTS CAN BE EDITED IN THE EVENT DRIVER (ED) SECTION OF THE
QUESTIONNAIRE.

BOX_01
IF DISCHARGE DATE CODED '95' (STILL IN HOSPITAL) FOR ANY HOSPITAL STAY
(HS) EVENT REPORTED IN PREVIOUS ROUND FOR ANY RU MEMBER, CONTINUE WITH
LOOP_01
OTHERWISE, GO TO BOX_02

LOOP_01
FOR EACH ELEMENT IN THE RU-MEMBERS-ROSTER, ASK PP01 - END_LP01
LOOP DEFINITION: LOOP_01 COLLECTS THE DISCHARGE DATE OF A HOSPITAL STAY
FOR ANY PERSON STILL IN THE HOSPITAL AT THE END OF THE PREVIOUS ROUND.
THIS LOOP CYCLES ON PERSONS THAT MEET BOTH OF THE FOLLOWING CONDITIONS:
- PERSON HAD AN HS EVENT DURING THE PREVIOUS ROUND
AND
- ONE OF PERSON’S HS EVENTS HAD A
DISCHARGE DATE CODED ‘95’ (STILL IN HOSPITAL).

1

Provider Probes (PP) Section
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PP01

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EVPV.EVNTENDY

EVENT END DATE - YEAR

Label

Size
4

EVPV.EVNTENDM
EVPV.EVNTENDD

EVENT END DATE - MONTH
EVENT END DATE - DAY

2
2

EVNT.EVNTENDM
EVNT.EVNTENDD

EVENT END DATE - MONTH
EVENT END DATE - DAY

2
2

EVNT.EVNTENDY

EVENT END DATE - YEAR

4

EVNT.PROCFLAG

EVNT UTILIZATION PROCESS FLAG

2

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER......} {ADM-DT}
Last time, we recorded that (PERSON) entered (PROVIDER) on (ADMIT
DATE) and was still in the hospital at the time of our interview on {PREV RD
INTV DT}.
On what date was (PERSON) discharged from (PROVIDER)?
IF STILL IN HOSPITAL, {OR RELEASED IN 2009}, ENTER 95 IN MONTH
FOR DISCHARGE DATE.
{Admit Date} [Enter Month, Day,Year]

{END_LP01}

{Admit Date} [Enter Month, Day,Year]
{Admit Date} [Enter Month, Day,Year]

{END_LP01}
{END_LP01}

DISPLAY INSTRUCTIONS:
DISPLAY THE DATE OF THE PREVIOUS ROUND’S INTERVIEW FOR ‘{PREV
RD INTV DT}’.
DISPLAY 'OR RELEASED IN 2009' IF ROUND 5.
DISPLAY.

Roster Details
Title:

PERS_EVNT_Edit_1

2

OTHERWISE, USE NULL

Provider Probes (PP) Section
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Col #

Header

Instructions

1

ADMIT DATE

Display Event Begin Date
EVNT.EVNTBEGM, EVNT.EVNTBEGD,
EVNT.EVNTBEGY

2

DISCHARGE DATE

Enter Event End Date
EVNT.EVNTENDM, EVNT.EVNTENDD,
EVNT.EVNTENDY

Roster Definition:
This item displays the PERSON’S-MEDICAL-EVENTS-ROSTER for
entering the discharge date for all open-ended hospital stays.
Roster Behavior:
1. Select, add, and delete disallowed.
2. Limited edit allowed. ADMIT DATE is a protected field.
Interviewer can update DISCHARGE DATE.
Roster Filter:
Displays all HS events that were coded ‘95’ (STILL IN
HOSPITAL) in the previous round.

END_LP01
CYCLE ON NEXT PERSON IN THE RU-MEMBERS-ROSTER WHO MEETS THE CONDITIONS
STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_01 AND CONTINUE
WITH BOX_02

BOX_02
IF DISCHARGE DATE CODED '95' (STILL IN INSTITUTION) FOR ANY INSTITUTIONAL
STAY (IC) EVENT REPORTED IN PREVIOUS ROUND FOR ANY RU MEMBER, CONTINUE
WITH LOOP_02
OTHERWISE, GO TO BOX_03

LOOP_02
FOR EACH ELEMENT IN RU-MEMBERS-ROSTER, ASK PP02 - END_LP02
LOOP DEFINITION: LOOP_02 COLLECTS THE DISCHARGE DATE OF AN INSTITUTIONAL
STAY FOR ANY PERSON STILL IN THE INSTITUTION AT THE END OF THE PREVIOUS
ROUND. THIS LOOP CYCLES ON PERSONS THAT MEET THE FOLLOWING CONDITIONS:
- PERSON HAD AT LEAST ONE IC EVENT DURING THE PREVIOUS ROUND
AND
- ONE OF PERSON’S IC EVENTS HAD A DISCHARGE DATE CODED ‘95’ (STILL IN
INSTITUTION).

3

Provider Probes (PP) Section
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PP02

Help Enabled

Comment Enabled

Jump Back Enabled

Variable Name
EVPV.EVNTENDY

EVENT END DATE - YEAR

Label

Size
4

EVPV.EVNTENDM
EVPV.EVNTENDD

EVENT END DATE - MONTH
EVENT END DATE - DAY

2
2

EVNT.EVNTENDM
EVNT.EVNTENDD

EVENT END DATE - MONTH
EVENT END DATE - DAY

2
2

EVNT.EVNTENDY

EVENT END DATE - YEAR

4

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE
PROVIDER......} {ADM-DT}
Last time we recorded that (PERSON) entered (PROVIDER) on (ADMIT
DATE) and was still there at the time of our interview on {PREV RD INTV DT}.
On what date was (PERSON) discharged from (PROVIDER)?
IF STILL IN AN INSTITUTION OR LONG TERM CARE FACILITY, {OR
RELEASED IN 2009}, ENTER 95 IN MONTH FOR DISCHARGE DATE.
{Admit Date} [Enter Month, Day,Year]
{Admit Date} [Enter Month, Day,Year]

{END_LP02}
{END_LP02}

{Admit Date} [Enter Month, Day,Year]

{END_LP02}

DISPLAY INSTRUCTIONS:
DISPLAY THE DATE OF THE PREVIOUS ROUND’S INTERVIEW FOR ‘{PREV
RD INTV DT}’.
DISPLAY 'OR RELEASED IN 2009' IF ROUND 5.
DISPLAY.

Roster Details
Title:

PERS_EVNT_Edit_2

4

OTHERWISE, USE NULL

Provider Probes (PP) Section
Beta

Col #

Header

Instructions

1

ADMIT DATE

Display Event Begin Date
EVNT.EVNTBEGM, EVNT.EVNTBEGD,
EVNT.EVNTBEGY

2

DISCHARGE DATE

Enter Event End Date
EVNT.EVNTENDM, EVNT.EVNTENDD,
EVNT.EVNTENDY

Roster Definition:
This item displays the PERSON’S-MEDICAL-EVENTS-ROSTER for
entering the discharge date for all open-ended stays in
institutions.
Roster Behavior:
1. Select, add, and delete disallowed.
2. Limited edit allowed. ADMIT DATE is a protected field.
Interviewer can update DISCHARGE DATE.
Roster Filter:
Displays all IC events that were coded ‘95’ (STILL IN
INSTITUTION) in the previous round.

END_LP02
CYCLE ON NEXT PERSON IN THE RU-MEMBERS-ROSTER WHO MEETS THE CONDITIONS
STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_02 AND CONTINUE
WITH BOX_03

BOX_03
IF CA03 IS CODED '5' (VOLUNTEERED NO EVENTS TO RECORD), GO TO PP03A
IF CA03 IS CODED '3' (SOME VISITS RECORDED), '4' (DID NOT USE), 'RF'
(REFUSED), 'DK' (DON'T KNOW), OR IS NOT ASKED (CALENDAR NEVER USED), GO TO
PP14
OTHERWISE, CONTINUE WITH LOOP_03

5

Provider Probes (PP) Section
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LOOP_03
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_04 - END_LP03
LOOP DEFINITION: LOOP_03 ASKS THE EVENT ROSTER (EV) SECTION FOR EACH
EVENT RECORDED ON THE CALENDAR. THE RESPONSE TO PP03 DETERMINES WHETHER
THE LOOP CYCLES AGAIN. IF PP03 IS CODED ‘1’ (YES), THE LOOP CYCLES TO
COLLECT THE NEXT EVENT. IF PP03 IS CODED ‘2’ (NO) OR ‘3’ (NO EVENTS ON
CALENDAR TO RECORD), THE LOOP ENDS.

BOX_04
IF FIRST CYCLE OF LOOP_03, GO TO PP03
OTHERWISE, CONTINUE WITH BOX_05

BOX_05
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP03

6

Provider Probes (PP) Section
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PP03

Help Enabled

Comment Enabled

Jump Back Enabled

INTERVIEWER: ADD (AN/ANOTHER) EVENT?
YES

1

{END_LP03}

NO
{NO EVENTS ON CALENDAR TO
RECORD}

2
{3}

{END_LP03}
{END_LP03}

DISPLAY INSTRUCTIONS:
DISPLAY CODE 3 (NO EVENTS ON CALENDAR TO RECORD), ONLY IF
FIRST CYCLE OF LOOP_03. OTHERWISE, USE A NULL DISPLAY.

END_LP03
IF PP03 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP03 IS CODED ‘2’ (NO) OR ‘3’ (NO EVENTS ON CALENDAR TO RECORD), END
LOOP_03 AND CONTINUE WITH PP03A

7

Provider Probes (PP) Section
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PP03A

Help Enabled

Comment Enabled

Jump Back Enabled

{STR-DT} {END-DT}
As you know, it is important for us to get complete and accurate information of
all of the family's health care events. I'd like you to take a few minutes to look
at several lists of health care providers, to be sure we haven't missed any
visits or calls, including those made just for advice, prescriptions, tests, shots,
or x-rays. Please be sure to include any visits or phone calls to a health care
provider that you haven’t told me about that were related to any health
conditions we may have already discussed.
PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.

8

Provider Probes (PP) Section
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PP04

Help Enabled (PROVMED)
Variable Name
HOME.MDMNDNPR

Comment Enabled

Jump Back Enabled

Label
ANY RU MEMB CONSULT A MED PROVIDER?

Size
2

{STR-DT}{END-DT}
SHOW CARD PP-1.
{Since (START DATE)/Between (START DATE) and (END DATE)}, has
anyone in the family seen or spoken with a medical or mental health
professional, dentist, or other health care provider listed on this card [other
than what we have already talked about]?
YES
NO

1
2

{LOOP_04}
{PP06}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP06}
{PP06}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

9

Provider Probes (PP) Section
Beta

LOOP_04
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_06 - END_LP04
LOOP DEFINITION: LOOP_04 COLLECTS ALL DENTAL (DN) AND MEDICAL PROVIDER
VISIT (MV) EVENTS NOT ALREADY RECORDED.
THE RESPONSE TO PP05 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP05 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP05 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

BOX_06
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP05

10

Provider Probes (PP) Section
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PP05

Help Enabled (PROVMED)

Comment Enabled

Jump Back Enabled

{STR-DT}{END-DT}
SHOW CARD PP-1.
Has {PERSON’S FIRST MIDDLE AND LAST NAME} had any other visits or
calls to health care providers listed on this card? Or has anyone else in the
family visited or called a health care provider listed here? [Please include any
visits or calls we have not yet talked about.]
YES

1

{END_LP04}

NO

2

{END_LP04}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP04}
{END_LP04}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY THE NAME OF THE PERSON FOR WHOM AN EVENT WAS JUST
ADDED FOR ‘{PERSON’S FIRST MIDDLE AND LAST NAME}’.

END_LP04
IF PP05 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP05 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_04 AND CONTINUE WITH PP06

11

Provider Probes (PP) Section
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PP06

Help Enabled (HOSP)
Variable Name
HOME.HSEROPIC

Comment Enabled

Jump Back Enabled

Label
ANY RU MEMB GET CARE AT HOSP OR LTC?

Size
2

{STR-DT} {END-DT}
SHOW CARD PP-2.
{Has/Between (START DATE) and (END DATE), has} anyone in the family
been a patient in a hospital or been seen in a hospital emergency room or
outpatient department? Or has anyone been a patient in any type of long term
care facility? [Please include any hospital care we have not yet talked about.]
YES
NO

1
2

{LOOP_05}
{PP07A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP07A}
{PP07A}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Has' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE), has' IF ROUND 5.

12

Provider Probes (PP) Section
Beta

LOOP_05
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_07 - END_LP05.
LOOP DEFINITION: LOOP_05 COLLECTS ALL HOSPITAL BASED AND INSTITUTIONAL
STAY EVENTS (I.E., HS, ER, OP, AND IC EVENTS) NOT ALREADY RECORDED.
THE RESPONSE TO PP07 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP07 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP07 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

BOX_07
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP07

13

Provider Probes (PP) Section
Beta

PP07

Help Enabled (HOSP)

Comment Enabled

Jump Back Enabled

{STR-DT} {END-DT}
SHOW CARD PP-2.
Has {PERSON’S FIRST MIDDLE AND LAST NAME} had any other visits to a
hospital or long term care facility? Or has anyone else in the family been a
patient in or seen at a hospital or long term care facility? [Please include any
hospital care we have not yet talked about.]
YES

1

{END_LP05}

NO

2

{END_LP05}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP05}
{END_LP05}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY THE NAME OF THE PERSON FOR WHOM AN EVENT WAS JUST
ADDED FOR ‘{PERSON’S FIRST MIDDLE AND LAST NAME}’.

END_LP05
IF PP07 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP07 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_05 AND CONTINUE WITH PP07A

14

Provider Probes (PP) Section
Beta

PP07A

Help Enabled
Variable Name
HOME.LABXRAY

Comment Enabled

Jump Back Enabled

Label

Size
2

ANY RU MEMB GET LAB OR XRAY

{STR-DT}{END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, has
anyone in the family had any visits to an independent lab or testing facility for
x-rays or other tests?
YES
NO

1
2

{LOOP_05A}
{PP07B}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP07B}
{PP07B}

DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

LOOP_05A
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_07A - END_LP05A.
LOOP DEFINITION: LOOP_05A COLLECTS ALL LAB EVENTS (I.E., OP, OR MV
EVENTS) NOT ALREADY RECORDED.
THE RESPONSE TO PP07AA DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF
PP07AA IS CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF
PP07AA IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP
ENDS.

15

Provider Probes (PP) Section
Beta

BOX_07A
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP07AA

PP07AA

Help Enabled

Comment Enabled

Jump Back Enabled

{STR-DT}{END-DT}
Has {PERSON’S FIRST MIDDLE AND LAST NAME} had any other visits to an
independent lab or testing facility? Or has anyone else in the family been
seen at an independent lab or testing facility? [Please include any care we
have not yet talked about.]
YES

1

{END_LP05A}

NO

2

{END_LP05A}

----------------------------------------------------------------------------------------------------------------------------------

Refused

RF

{END_LP05A}

Don't Know

DK

{END_LP05A}

DISPLAY INSTRUCTIONS:
DISPLAY THE NAME OF THE PERSON FOR WHOM AN EVENT WAS JUST
ADDED FOR ‘{PERSON’S FIRST MIDDLE AND LAST NAME}’.

END_LP05A
IF PP07AA IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP07AA IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_05A AND CONTINUE WITH PP07B

16

Provider Probes (PP) Section
Beta

PP07B

Help Enabled
Variable Name
HOME.ALTCARE

Comment Enabled

Jump Back Enabled

Label

Size
2

ANY RU MEMB GET ALTRNTV CARE

{STR-DT}{END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, has
anyone in the family had any visits to someone who practices alternative care
such as acupuncture, massage therapy, hypnosis, or other treatments?
YES
NO

1
2

{LOOP_05B}
{PP08}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP08}
{PP08}

DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

LOOP_05B
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_07B - END_LP05B.
LOOP DEFINITION: LOOP_05B COLLECTS ALL ALTERNATIVE CARE EVENTS (I.E., MV
EVENTS) NOT ALREADY RECORDED.
THE RESPONSE TO PP07BB DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF
PP07BB IS CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF
PP07BB IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP
ENDS.

17

Provider Probes (PP) Section
Beta

BOX_07B
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP07BB

PP07BB

Help Enabled

Comment Enabled

Jump Back Enabled

{STR-DT} {END-DT}
Has {PERSON’S FIRST MIDDLE AND LAST NAME} had any other visits to
someone who practices alternative care? Or has anyone else in the family
been seen by someone who practices alternative care? [Please include any
alternative care we have not yet talked about.]
YES

1

{END_LP05B}

NO

2

{END_LP05B}

----------------------------------------------------------------------------------------------------------------------------------

Refused

RF

{END_LP05B}

Don't Know

DK

{END_LP05B}

DISPLAY INSTRUCTIONS:
DISPLAY THE NAME OF THE PERSON FOR WHOM AN EVENT WAS JUST
ADDED FOR ‘{PERSON’S FIRST MIDDLE AND LAST NAME}’.

END_LP05B
IF PP07BB IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP07BB IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_05B AND CONTINUE WITH PP08

18

Provider Probes (PP) Section
Beta

PP08

Help Enabled (HOMEHLTH)
Variable Name
HOME.HOMEHLTH

Comment Enabled

Jump Back Enabled

Label
ANY RU MEMB GET HOME HEALTH CARE?

Size
2

{STR-DT} {END-DT}
SHOW CARD PP-3.
What about visits to the home because of a health problem for any of these
services {between (START DATE) and (END DATE)}? [Please include any
home care services we have not yet talked about.]
YES
NO

1
2

{LOOP_06}
{PP12}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP12}
{PP12}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'between (START DATE) and (END DATE)' IF ROUND 5.
OTHERWISE, USE A NULL DISPLAY.

LOOP_06
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_08 - END_LP06.
LOOP DEFINITION:
RECORDED.

LOOP_06 COLLECTS ALL HOME HEALTH (HH) EVENTS NOT ALREADY

THE RESPONSE TO PP09 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP09 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP09 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

19

Provider Probes (PP) Section
Beta

BOX_08
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP09

PP09

Help Enabled (HOMEHLTH)

Comment Enabled

Jump Back Enabled

{STR-DT} {END-DT}
SHOW CARD PP-3.
Because of a health problem, has {PERSON’S FIRST MIDDLE AND LAST
NAME} received any other home care services? Or has anyone else in the
family received home care services such as those listed on this card? [Please
include any home care services we have not yet talked about.]
YES

1

{END_LP06}

NO

2

{END_LP06}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP06}
{END_LP06}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY THE NAME OF THE PERSON FOR WHOM AN EVENT WAS JUST
ADDED FOR ‘{PERSON’S FIRST MIDDLE AND LAST NAME}’.

END_LP06
IF PP09 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP09 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_06 AND CONTINUE WITH PP12

20

Provider Probes (PP) Section
Beta

PP12

Help Enabled (OMES)
Variable Name
HOME.EYEGLDIB

Comment Enabled

Jump Back Enabled

Label
ANY RU MEMB GET VISION OR DIAB EQUIP?

Size
2

{STR-DT} {END-DT}
SHOW CARD PP-4.
{And finally/Between (START DATE) and (END DATE)}, did anyone in the
family obtain eyeglasses, contact lenses, or diabetic equipment {since
(START DATE)} [other than what we have already talked about]?
YES

1

{LOOP_07}

NO

2

{BOX_09A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_09A}
{BOX_09A}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'And finally' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
NULL DISPLAY.

21

OTHERWISE, USE A

Provider Probes (PP) Section
Beta

LOOP_07
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_09 - END_LP07.
LOOP DEFINITION: LOOP_07 COLLECTS ALL OTHER MEDICAL EXPENSE (OM) EVENTS
NOT ALREADY RECORDED.
THE RESPONSE TO PP13 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP13 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP13 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

BOX_09
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP13

PP13

Help Enabled (OMES)

Comment Enabled

Jump Back Enabled

{STR-DT} {END-DT}
SHOW CARD PP-4.
Has anyone else in the family obtained eyeglasses, contact lenses, or diabetic
equipment [other than what we have already talked about]?
YES

1

{END_LP07}

NO

2

{END_LP07}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP07}
{END_LP07}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.

22

Provider Probes (PP) Section
Beta

END_LP07
IF PP13 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP13 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_07 AND CONTINUE WITH BOX_09A

BOX_09A
IF ROUND 3 OR ROUND 5, CONTINUE WITH PP13A
OTHERWISE, GO TO BOX_10

23

Provider Probes (PP) Section
Beta

PP13A

Help Enabled (OTHOMES)
Variable Name
HOME.OMALLYR

Comment Enabled

Jump Back Enabled

Label
ANYONE OBTAIN OM DURING THE YEAR 1996?

Size
2

JAN 01 DEC 31
SHOW CARD PP-4A.
Now I would like you to think about the entire calendar year {YEAR}, that is
from January 1, {YEAR} until December 31, {YEAR}.
Please look at the types of other medical expenses listed on this card. Did
anyone in the family obtain any of these types of other medical expenses
during the year {YEAR}?
PROBE: These could include ambulance services, canes, wheelchairs,
corrective shoes, hearing aids or amplifiers for a telephone, artificial limbs,
raised toilet seats, a modification to the house or a car because of some
illness or injury, for example ramps or handrails, etc.
YES

1

{LOOP_07A}

NO

2

{BOX_10}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_10}
{BOX_10}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
(FOR SPECIFICATIONS PURPOSE ONLY, YEAR IN PROGRAM IS
AUTOMATICALLY SET.)
IF ROUND 3, DISPLAY FIRST YEAR OF PANEL FOR 'YEAR.'
IF ROUND 5, DISPLAY SECOND YEAR OF PANEL FOR 'YEAR.'

24

Provider Probes (PP) Section
Beta

LOOP_07A
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_09B - END_LP07A.
LOOP DEFINITION: LOOP_07A COLLECTS ALL OTHER TYPES OF MEDICAL EXPENSE
(OM) EVENTS FOR THE CALENDAR YEAR. IF ROUND 3, THE YEAR IS THE FIRST
CALENDAR YEAR OF THE PANEL. IF ROUND 5 THE YEAR IS THE SECOND CALENDAR
YEAR OF THE PANEL NOT ALREADY RECORDED.
THE RESPONSE TO PP13B DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP13B
IS CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP13B
IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

BOX_09B
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP13B

25

Provider Probes (PP) Section
Beta

PP13B

Help Enabled (OTHOMES)

Comment Enabled

Jump Back Enabled

JAN 01 DEC 31
SHOW CARD PP-4A.
During the calendar year {YEAR}, has anyone else in the family obtained,
purchased, or rented any of the types of other medical expenses listed on this
card [other than what we have already talked about]?
YES
NO

1
2

{END_LP07A}
{END_LP07A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP07A}
{END_LP07A}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
(FOR SPECIFICATIONS PURPOSE ONLY, YEAR IN PROGRAM IS
AUTOMATICALLY SET.)
IF ROUND 3, DISPLAY FIRST YEAR OF PANEL FOR 'YEAR.'
IF ROUND 5, DISPLAY SECOND YEAR OF PANEL FOR 'YEAR.'

END_LP07A
IF PP13B IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP13B IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_07A AND CONTINUE WITH BOX_10

BOX_10
GO TO BOX_18

26

Provider Probes (PP) Section
Beta

PP14

Help Enabled

Comment Enabled

Jump Back Enabled

{STR-DT} {END-DT}
These next questions ask about the different medical and dental care anyone
in the family has received {since (START DATE)/between (START DATE) and
(END DATE)}. It is sometimes hard to remember dates accurately so take
your time. You might want to look at any calendar you may keep, checkbook,
or receipts to help you remember. We are interested in any type of visit or
call, including those made just for advice, prescriptions, tests, shots, or x-rays.
Also include any visits or phone calls to a health care provider that were
related to any conditions we may have discussed.
PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.
DISPLAY INSTRUCTIONS:
DISPLAY 'since (START DATE)' IF NOT ROUND 5.
DISPLAY 'between (START DATE) and (END DATE) IF ROUND 5.

LOOP_08
FOR EACH ELEMENT ON THE RU-MEMBERS-ROSTER, ASK PP15 - END_LP08.
LOOP DEFINITION: LOOP_08 COLLECTS ALL EVENTS FOR EACH RU MEMBER WHEN THE
CALENDAR IS INCOMPLETE OR WAS NOT USED. THIS LOOP CYCLES ON ALL ELIGIBLE
RU MEMBERS INCLUDING PERSONS WHO WERE DECEASED OR INSTITUTIONALIZED AFTER
THE REFERENCE PERIOD START DATE.

27

Provider Probes (PP) Section
Beta

PP15

Help Enabled (DENTPROV)
Variable Name
PRND.PERSGO

Comment Enabled

Jump Back Enabled

Label
DID PERS CONSULT DENT PROV? (CARD PP-5)

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-5.
Now think about the health care (PERSON) has received {since (START
DATE)/between (START DATE) and (END DATE)}.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) see or talk to any type of dental care provider, such as the types
listed on this card, for dental care or a dental check-up?
YES
NO

1
2

{LOOP_09}
{PP17}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP17}
{PP17}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'since (START DATE)' and 'Since (START DATE)' IF NOT
ROUND 5.
DISPLAY 'between (START DATE) and (END DATE)' and 'Between
(START DATE) and (END DATE)' IF ROUND 5.

28

Provider Probes (PP) Section
Beta

LOOP_09
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_11- END_LP09.
LOOP DEFINITION: LOOP_09 COLLECTS ALL DENTAL (DN) EVENTS NOT ALREADY
RECORDED FOR PERSON BEING ASKED ABOUT.
THE RESPONSE TO PP16 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP16 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP16 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

BOX_11
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP16

29

Provider Probes (PP) Section
Beta

PP16

Help Enabled (DENTPROV)

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-5.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) see or talk to any other type of dental care provider, such as the
types listed on this card (other than what you’ve already told me about)?
YES
NO

1
2

{END_LP09}
{END_LP09}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP09}
{END_LP09}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP09
IF PP16 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP16 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_09 AND CONTINUE WITH PP17

30

Provider Probes (PP) Section
Beta

PP17

Help Enabled (OTHMEDPROV)
Variable Name
PRND.PTSTSHOT

Comment Enabled

Jump Back Enabled

Label
DID PERS CONSULT MED PROV? (CARD PP-6)

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-6.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) see or talk to any medical doctor or nurse, such as those types
listed on this card? [Please include telephone calls or visits where (PERSON)
received advice, prescriptions, or test results.]
YES
NO

1
2

{LOOP_10}
{PP19}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP19}
{PP19}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

31

Provider Probes (PP) Section
Beta

LOOP_10
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_12 - END_LP10.
LOOP DEFINITION: LOOP_10 COLLECTS ALL MEDICAL PROVIDER VISIT (MV) EVENTS
NOT ALREADY RECORDED FOR PERSON BEING ASKED ABOUT.
THE RESPONSE TO PP18 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP18 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP18 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK' (DON’T KNOW), THE LOOP ENDS.

BOX_12
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP18

32

Provider Probes (PP) Section
Beta

PP18

Help Enabled (OTHMEDPROV)

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-6.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) see or talk to any other type of medical professional, such as the
types listed on this card (other than what you’ve already told me about)?
YES
NO

1
2

{END_LP10}
{END_LP10}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP10}
{END_LP10}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP10
IF PP18 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP18 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_10 AND CONTINUE WITH PP19

33

Provider Probes (PP) Section
Beta

PP19

Help Enabled (OPATEMER)
Variable Name
PRND.PGOCLOPD

Comment Enabled

Jump Back Enabled

Label
DID PERS GET CARE IN OR FROM HOSPITAL?

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-7.
{Since (START DATE)/Between (START DATE) and (END DATE)}, was
(PERSON) a patient in a hospital or receive care in a hospital emergency
room or hospital outpatient department?
YES

1

{LOOP_11}

NO

2

{PP21}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP21}
{PP21}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

LOOP_11
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_13 - END_LP11.
LOOP DEFINITION: LOOP_11 COLLECTS ALL HOSPITAL BASED EVENTS (I.E., HS,
ER, AND OP EVENTS) NOT ALREADY RECORDED FOR PERSON BEING ASKED ABOUT.
THE RESPONSE TO PP20 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP20 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP20 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

34

Provider Probes (PP) Section
Beta

BOX_13
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP20

PP20

Help Enabled (OPATEMER)

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-7.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) receive any other care as a patient in a hospital or from a hospital
emergency room or outpatient department (other than what you’ve already
told me about)?
YES

1

{END_LP11}

NO

2

{END_LP11}

----------------------------------------------------------------------------------------------------------------------------------

Refused

RF

{END_LP11}

Don't Know

DK

{END_LP11}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP11
IF PP20 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP20 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_11 AND CONTINUE WITH PP21

35

Provider Probes (PP) Section
Beta

PP21

Help Enabled (OTHMEDPERS)
Variable Name
PRND.POTMDPRS

Comment Enabled

Jump Back Enabled

Label
DID PERS CONSULT OTH MED PERSONS?

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-8.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) see or talk to any of the health care providers listed on this card?
YES
NO

1
2

{LOOP_12}
{PP22A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP22A}
{PP22A}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

LOOP_12
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_14 - END_LP12.
LOOP DEFINITION: LOOP_12 COLLECTS ALL MEDICAL PROVIDER VISIT (MV) EVENTS
NOT ALREADY RECORDED FOR PERSON BEING ASKED ABOUT.
THE RESPONSE TO PP22 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP22 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP22 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

36

Provider Probes (PP) Section
Beta

BOX_14
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP22

PP22

Help Enabled (OTHMEDPERS)

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-8.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) see or talk to any other type of health care provider, such as the
types listed on this card (other than what you’ve already told me about)?
YES
NO

1
2

{END_LP12}
{END_LP12}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP12}
{END_LP12}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP12
IF PP22 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP22 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_12 AND CONTINUE WITH PP22A

37

Provider Probes (PP) Section
Beta

PP22A

Help Enabled
Variable Name
PRND.PLABXRAY

Comment Enabled

Jump Back Enabled

Label

Size
2

DID PERSON RECEIVE LAB/XRAY

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) have any visits to an independent lab or testing facility for x-rays or
other tests?
YES
NO

1
2

{LOOP_12A}
{PP22B}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP22B}
{PP22B}

DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

LOOP_12A
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_14A - END_LP12A.
LOOP DEFINITION: LOOP_12A COLLECTS ALL LAB EVENTS (I.E., OP, OR MV
EVENTS) NOT ALREADY RECORDED.
THE RESPONSE TO PP22AA DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF
PP22AA IS CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF
PP22AA IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP
ENDS.

38

Provider Probes (PP) Section
Beta

BOX_14A
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP22AA

PP22AA

Help Enabled

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) have any other visits to an independent lab or testing facility (other
than what you’ve already told me about)?
YES

1

{END_LP12A}

NO

2

{END_LP12A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP12A}
{END_LP12A}

DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP12A
IF PP22AA IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP22AA IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_12A AND CONTINUE WITH PP22B.

39

Provider Probes (PP) Section
Beta

PP22B

Help Enabled
Variable Name
PRND.PALTCARE

Comment Enabled

Jump Back Enabled

Label
DID PERSON RECEIVE ALTRNTV CARE

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) have any visits to someone who practices alternative care such as
acupuncture, massage therapy, hypnosis, or other treatments?
YES
NO

1
2

{LOOP_12B}
{PP23}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP23}
{PP23}

DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

LOOP_12B
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_14B - END_LP12B.
LOOP DEFINITION: LOOP_12B COLLECTS ALL ALTERNATIVE CARE EVENTS (I.E., MV
EVENTS) NOT ALREADY RECORDED.
THE RESPONSE TO PP22BB DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF
PP22BB IS CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF
PP22BB IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP
ENDS.

40

Provider Probes (PP) Section
Beta

BOX_14B
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP22BB

PP22BB

Help Enabled

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) have any other visits to someone who practices alternative care
(other than what you’ve already told me about)?
YES

1

{END_LP12B}

NO

2

{END_LP12B}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP12B}
{END_LP12B}

DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP12B
IF PP22BB IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP22BB IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_12B AND CONTINUE WITH PP23

41

Provider Probes (PP) Section
Beta

PP23

Help Enabled (HOMEHLTH)
Variable Name
PRND.PRECHLP

Comment Enabled

Jump Back Enabled

Label
DID PERS RECEIVE ANY HOME HLTH CARE

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-9.
{Since (START DATE)/Between (START DATE) and (END DATE)}, because
of a health problem, did (PERSON) receive any home care services such as
the types listed on this card? Please include home care services received for
medical care, personal care, supervision, and household help.
YES

1

{LOOP_13}

NO

2

{PP25}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP25}
{PP25}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

42

Provider Probes (PP) Section
Beta

LOOP_13
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_15 - END_LP13.
LOOP DEFINITION: LOOP_13 COLLECTS ALL HOME HEALTH (HH) EVENTS NOT ALREADY
RECORDED FOR PERSON BEING ASKED ABOUT.
THE RESPONSE TO PP24 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP24 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP24 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

BOX_15
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP24

43

Provider Probes (PP) Section
Beta

PP24

Help Enabled (HOMEHLTH)

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-9.
{Since (START DATE)/Between (START DATE) and (END DATE)}, because
of a health problem, did (PERSON) receive home care services such as the
types listed on this card (other than what you’ve already told me about)?
YES

1

{END_LP13}

NO

2

{END_LP13}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP13}
{END_LP13}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP13
IF PP24 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP24 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_13 AND CONTINUE WITH PP25

44

Provider Probes (PP) Section
Beta

PP25

Help Enabled (LTC)
Variable Name
PRND.PLTCHOSP

Comment Enabled

Jump Back Enabled

Label
WAS PERS IN LONG TERM CARE FACILITY

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-10.
{Since (START DATE)/Between (START DATE) and (END DATE)},
(were/was) (PERSON) a patient in any long term care facility, such as the
types of places listed on this card?
YES

1

{LOOP_14}

NO

2

{PP27}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{PP27}
{PP27}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

LOOP_14
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_16 - END_LP14.
LOOP DEFINITION: LOOP_14 COLLECTS ALL INSTITUTIONAL (IC) EVENTS NOT
ALREADY RECORDED FOR PERSON BEING ASKED ABOUT.
THE RESPONSE TO PP26 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP26 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP26 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

45

Provider Probes (PP) Section
Beta

BOX_16
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP26

PP26

Help Enabled (LTC)

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-10.
{Since (START DATE)/Between (START DATE) and (END DATE)},
(were/was) (PERSON) a patient in any other long term care facility, such as
the types of places listed on this card (other than what you’ve already told me
about)?
YES

1

{END_LP14}

NO

2

{END_LP14}

----------------------------------------------------------------------------------------------------------------------------------

Refused

RF

{END_LP14}

Don't Know

DK

{END_LP14}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP14
IF PP26 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP26 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_14 AND CONTINUE WITH PP27

46

Provider Probes (PP) Section
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PP27

Help Enabled (OMES)
Variable Name
PRND.PBUYOTHR

Comment Enabled

Jump Back Enabled

Label
DID PERS USE/BUY OTHER MED SUPPLIES

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-11.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) obtain eyeglasses, contact lenses, or diabetic equipment?
YES
NO

1
2

{LOOP_15}
{BOX_17A}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{BOX_17A}
{BOX_17A}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

LOOP_15
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_17 - END_LP15.
LOOP DEFINITION: LOOP_15 COLLECTS ALL OTHER MEDICAL EXPENSE (OM) EVENTS
NOT ALREADY RECORDED FOR PERSON BEING ASKED ABOUT.
THE RESPONSE TO PP28 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP28 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP28 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

47

Provider Probes (PP) Section
Beta

BOX_17
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP28

PP28

Help Enabled (OMES)

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT} {END-DT}
SHOW CARD PP-11.
{Since (START DATE)/Between (START DATE) and (END DATE)}, did
(PERSON) obtain any other medical supplies listed on this card (other than
what you’ve already told me about)?
YES
NO

1
2

{END_LP15}
{END_LP15}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP15}
{END_LP15}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
DISPLAY 'Since (START DATE)' IF NOT ROUND 5.
DISPLAY 'Between (START DATE) and (END DATE)' IF ROUND 5.

END_LP15
IF PP28 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP28 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_15 AND CONTINUE WITH BOX_17A

48

Provider Probes (PP) Section
Beta

BOX_17A
IF ROUND 3 OR ROUND 5, CONTINUE WITH PP29
OTHERWISE, GO TO END_LP08

49

Provider Probes (PP) Section
Beta

PP29

Help Enabled (OTHOMES)
Variable Name
PRND.OMALLYR

Comment Enabled

Jump Back Enabled

Label
PERSON OBTAIN OM DURING THE YEAR 1996?

Size
2

{PERSON’S FIRST MIDDLE AND LAST NAME} JAN 01 DEC 31
SHOW CARD PP-12.
Now I would like you to think about the entire calendar year {YEAR}, that is
from January 1, {YEAR} until December 31, {YEAR}.
Please look at the types of other medical expenses listed on this card. Did
(PERSON) obtain any of these types of other medical expenses during
the year {YEAR}?
PROBE: These could include ambulance services, canes, wheelchairs,
corrective shoes, hearing aids or amplifiers for a telephone, artificial limbs,
raised toilet seats, a modification to the house or a car because of some
illness or injury, for example ramps or handrails, etc.
YES

1

{LOOP_16}

NO

2

{END_LP08}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP08}
{END_LP08}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
(FOR SPECIFICATIONS PURPOSE ONLY, YEAR IN PROGRAM IS
AUTOMATICALLY SET.)
IF ROUND 3, DISPLAY FIRST YEAR OF PANEL FOR 'YEAR.'
IF ROUND 5, DISPLAY SECOND YEAR OF PANEL FOR 'YEAR.'

50

Provider Probes (PP) Section
Beta

LOOP_16
For each of the following:
EVENT
EVENT
EVENT
EVENT

1
2
3
4

ask BOX_17B - END_LP16.
LOOP DEFINITION: LOOP_16 COLLECTS ALL OTHER TYPES OF MEDICAL EXPENSE (OM)
EVENTS THAT ARE NOT ALREADY RECORDED FOR THE CALENDAR YEAR. IF ROUND 3,
THE YEAR IS THE FIRST CALENDAR YEAR OF THE PANEL. IF ROUND 5, THE YEAR IS
THE SECOND CALENDAR YEAR OF THE PANEL.
THE RESPONSE TO PP30 DETERMINES WHETHER THE LOOP CYCLES AGAIN. IF PP30 IS
CODED ‘1’ (YES), THE LOOP CYCLES TO COLLECT THE NEXT EVENT. IF PP30 IS
CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), THE LOOP ENDS.

BOX_17B
ASK THE EVENT ROSTER (EV) SECTION
AT COMPLETION OF THE EV SECTION, CONTINUE WITH PP30

51

Provider Probes (PP) Section
Beta

PP30

Help Enabled (OTHOMES)

Comment Enabled

Jump Back Enabled

{PERSON’S FIRST MIDDLE AND LAST NAME} JAN 01 DEC 31
SHOW CARD PP-12.
During the calendar year {YEAR}, (have/has) (PERSON) obtained, purchased,
or rented any of the types of other medical expenses listed on this card [other
than what we have already talked about]?
YES
NO

1
2

{END_LP16}
{END_LP16}

----------------------------------------------------------------------------------------------------------------------------------

Refused
Don't Know

RF
DK

{END_LP16}
{END_LP16}

HELP AVAILABLE FOR DEFINITION OF ITEMS ON SHOW CARD.
DISPLAY INSTRUCTIONS:
(FOR SPECIFICATIONS PURPOSE ONLY, YEAR IN PROGRAM IS
AUTOMATICALLY SET.)
IF ROUND 3, DISPLAY FIRST YEAR OF PANEL FOR 'YEAR.'
IF ROUND 5, DISPLAY SECOND YEAR OF PANEL FOR 'YEAR.'

END_LP16
IF PP30 IS CODED ‘1’ (YES), CYCLE TO COLLECT NEXT EVENT.
IF PP30 IS CODED ‘2’ (NO), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW), END
LOOP_16 AND CONTINUE WITH END_LP08

END_LP08
CYCLE ON NEXT PERSON IN THE RU-MEMBERS-ROSTER WHO MEETS THE CONDITIONS
STATED IN THE LOOP DEFINITION.
IF NO OTHER PERSONS MEET THE STATED CONDITIONS, END LOOP_08 AND CONTINUE
WITH BOX_18

52

Provider Probes (PP) Section
Beta

BOX_18
GO TO NEXT QUESTIONNAIRE SECTION.

53


File Typeapplication/pdf
File TitleC:\PP (BETA).snp
Authormiller_n
File Modified2005-08-10
File Created2005-08-10

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