MEPS-MPC-Fax Package

MPC List Interviewer Version.rtf

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

MEPS-MPC-Fax Package

OMB: 0935-0118

Document [pdf]
Download: pdf | pdf

Beta

Outpatient Department (OP) Section

OP02

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

Did (PERSON) visit the outpatient department at (PROVIDER) on (VISIT

DATE) in person or was this a telephone call?

Size

Variable Name

Label

OPAT.SEETLKPV

2

DID P VST OUTP PROV IN PERSON OR TELEPHN

1

SAW PROVIDER

{OP04}

2

TELEPHONE CALL

{OP04}

RF

Refused

{OP04}

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

DK

Don't Know

{OP04}

PROGRAMMER NOTES:

IF OP02 IS CODED ‘1’ (SAW PROVIDER) FLAG EVENT AS ‘OP-IN-

PERSON’.

IF OP02 IS CODED ‘2’ (TELEPHONE CALL), 'RF' (REFUSED), OR 'DK'

(DON'T KNOW), FLAG EVENT AS ‘OP-TELEPHONE’. (FOR PURPOSES OF

QUESTION WORDING IN THIS OP SECTION OF CAPI HOWEVER, 'RF' AND

'DK' WILL USE THE WORDING FOR 'DP-IN-PERSON' EVENTS).

1

Beta

Outpatient Department (OP) Section

OP04

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(MEDPROVHELP)

{Did (PERSON) see a medical doctor during this particular visit?/Was this

telephone call about (PERSON)’s health with a medical doctor?}

Size

Variable Name

Label

OPAT.SEEDOC

2

DID P TALK TO MD THIS VISIT/PHONE CALL

1

YES

{OP04A}

2

NO

{OP05}

RF

Refused

{OP05}

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

DK

Don't Know

{OP05}

HELP AVAILABLE FOR DEFINITION OF MEDICAL DOCTOR.

DISPLAY INSTRUCTIONS:

DISPLAY ‘Did (PERSON) see a medical doctor during this

particular visit?’ IF OP02 IS CODED ‘1’ (SAW PROVIDER), ‘RF’

(REFUSED), OR ‘DK’ (DON’T KNOW) FOR THIS EVENT.

DISPLAY ‘Was this telephone call about (PERSON)’s health with

a medical doctor?’ IF OP02 IS CODED ‘2’ (TELEPHONE CALL) FOR

THIS EVENT.

2

Beta

Outpatient Department (OP) Section

OP04A

{PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

What was the doctor’s specialty?

Size

Variable Name

Label

OPAT.DRSPLTY

2

MVIS DOCTOR'S SPECIALTY

IF TALKED TO MORE THAN ONE DOCTOR, PROBE FOR MAIN PROVIDER.

1

ALLERGY/IMMUNOLOGY

{BOX_01}

2

ANESTHESIOLOGY

{BOX_01}

3

CARDIOLOGY (HEART)

{BOX_01}

4

DERMATOLOGY (SKIN)

{BOX_01}

5

ENDOCRINOLOGY/METABOLISM

(DIABETES, THYROID)

{BOX_01}

6

FAMILY PRACTICE

{BOX_01}

7

GASTROENTEROLOGY

{BOX_01}

8

GENERAL PRACTICE

{BOX_01}

9

GENERAL SURGERY

{BOX_01}

10

GERIATRICS (ELDERLY)

{BOX_01}

11

GYNECOLOGY/OBSTETRICS

{BOX_01}

12

HEMATOLOGY (BLOOD)

{BOX_01}

13

HOSPITAL RESIDENCE

{BOX_01}

14

INTERNAL MEDICINE (INTERNIST)

{BOX_01}

15

NEPHROLOGY (KIDNEYS)

{BOX_01}

16

NEUROLOGY

{BOX_01}

17

NUCLEAR MEDICINE

{BOX_01}

18

ONCOLOGY (TUMORS, CANCER)

{BOX_01}

19

OPTHALMOLOGY (EYES)

{BOX_01}

20

ORTHOPEDICS

{BOX_01}

21

OSTEOPATHY (DO)

{BOX_01}

22

OTORHINOLARYNGOLOGY (EAR,

NOSE, THROAT)

{BOX_01}

3

Beta

Outpatient Department (OP) Section

23

PATHOLOGY

{BOX_01}

24

PEDIATRICIAN

{BOX_01}

25

PHYSICAL MEDICINE/REHAB

{BOX_01}

26

PLASTIC SURGERY

{BOX_01}

27

PROCTOLOGY

{BOX_01}

28

PSYCHIATRY/PSYCHIATRIST

{BOX_01}

29

PULMONARY

{BOX_01}

30

RADIOLOGY

{BOX_01}

31

RHEUMATOLOGY (ARTHRITIS)

{BOX_01}

32

THORACIC SURGERY (CHEST)

{BOX_01}

33

UROLOGY

{BOX_01}

91

OTHER DR SPECIALTY

{BOX_01}

RF

Refused

{BOX_01}

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

DK

Don't Know

{BOX_01}

4

Beta

Outpatient Department (OP) Section

OP05

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(OP05Help)

What type of medical person did (PERSON) talk to on (VISIT DATE)?

Size

Variable Name

Label

OPAT.MEDPTYPE

2

TYPE OF MED PERSON P TALKED TO ON VST DT

IF TALKED TO MORE THAN ONE MEDICAL PERSON, PROBE FOR MAIN

PROVIDER.

1

CHIROPRACTOR

{BOX_01}

2

DENTIST/DENTAL CARE PERSON

{BOX_01}

3

MIDWIFE

{BOX_01}

4

NURSE/NURSE PRACTITIONER

{BOX_01}

5

OPTOMETRIST

{BOX_01}

6

PODIATRIST

{BOX_01}

7

PHYSICIAN'S ASSISTANT

{BOX_01}

8

PHYSICAL THERAPIST

{BOX_01}

9

OCCUPATIONAL THERAPIST

{BOX_01}

10

PSYCHOLOGIST

{BOX_01}

11

SOCIAL WORKER

{BOX_01}

12

TECHNICIAN

{BOX_01}

14

ACUPUNCTURIST

{BOX_01}

15

MASSAGE THERAPIST

{BOX_01}

16

HOMEOPATHIC/NATUROPATHIC/HERBA

LIST

{BOX_01}

17

OTHER

ALTERNATIVE/COMPLEMENTARY

CARE PROVIDER

{BOX_01}

91

OTHER

{BOX_01}

RF

Refused

{BOX_01}

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

DK

Don't Know

{BOX_01}

5

Beta

Outpatient Department (OP) Section

HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.

BOX_01

IF OP02 IS CODED '2' (TELEPHONE CALL), 'RF' (REFUSED), OR 'DK' (DON'T

KNOW), GO TO OP08.

IF OP02 IS CODED '1' (SAW PROVIDER), CONTINUE WITH OP07.

6

Beta

Outpatient Department (OP) Section

OP07

SHOW CARD OP-1.

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(VSTCTGRYHELP)

Please look at this card and tell me which category best describes the care

(PERSON) received during the visit to the outpatient department at

(PROVIDER) on (VISIT DATE)?

Size

Variable Name

Label

OPAT.VSTCTGRY

2

BEST CATEGORY FOR CARE P RECV ON VST DT

1

GENERAL CHECKUP

{OP08}

2

DIAGNOSIS OR TREATMENT

{OP08}

3

EMERGENCY (E.G., ACCIDENT OR

INJURY)

{OP08}

4

PSYCHOTHERAPY OR MENTAL

HEALTH COUNSELING

{OP08}

5

FOLLOW-UP OR POST-OPERATIVE

VISIT

{OP08}

6

IMMUNIZATIONS OR SHOTS

{OP08}

7

VISION EXAM

{OP08}

8

PREGNANCY-RELATED (INCLUDING

PRENATAL CARE AND DELIVERY)

{OP08}

9

WELL CHILD EXAM

{OP08}

10

LASER EYE SURGERY

{OP08}

91

OTHER

{OP08}

RF

Refused

{OP08}

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

DK

Don't Know

{OP08}

HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.

Hard CHECK:

IF CODED ‘8’ (PREGNANCY-RELATED (INCLUDING PRENATAL CARE AND DELIVERY)),

CHECK THAT PERSON IS FEMALE. IF NOT, DISPLAY THE FOLLOWING MESSAGE: ‘CODE

7

Beta

Outpatient Department (OP) Section

UNAVAILABLE FOR MALES. VERIFY AND RE-ENTER.’

IF CODED ‘9’ (WELL CHILD EXAM), CHECK THAT PERSON IS <7 YEARS OLD (OR AGE

CATEGORIES 1 TO 3). IF NOT, DISPLAY THE FOLLOWING MESSAGE: ‘CODE

UNAVAILABLE FOR PERSONS 7 AND OLDER. VERIFY AND RE-ENTER.’

OP08

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

Was this {visit/telephone call} related to any specific health condition or were

any conditions discovered during this {visit/telephone call}?

Size

Variable Name

Label

OPAT.VSTRELCN

2

THIS VST/PHONE CALL RELATED TO SPEC COND

1

YES

{OP09}

2

NO

{BOX_02}

RF

Refused

{BOX_02}

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

DK

Don't Know

{BOX_02}

DISPLAY INSTRUCTIONS:

DISPLAY ‘visit’ IF OP02 IS CODED ‘1’ (SAW PROVIDER), ‘RF’

(REFUSED), OR ‘DK’ (DON’T KNOW) FOR THIS EVENT. DISPLAY

‘telephone call’ IF OP02 IS CODED ‘2’(TELEPHONE CALL) FOR THIS

EVENT.

8

Beta

Outpatient Department (OP) Section

OP09

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

What conditions were discovered or led (PERSON) to make this

{visit/telephone call}?

PROBE: Any other condition?

IF CONDITION IS ALREADY LISTED, ASK: Is this the same (NAME OF

CONDITION) that we have already talked about before?

Size

Variable Name

Label

COND.CONDID

12

COND ID KEY: PERSID + COUNTER(3) + CD

COND.CONDRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

COND.CREATEQ

4

QUESTION THAT CREATED COND SEGMENT

COND.CONDNAM

30

NAME OF CONDITION

CLNK.CLNKID

24

CLNK ID KEY: CONDID + EVNTID

CLNK.CLNKRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

CLNK.CREATEQ

4

QUESTION THAT CREATED CLNK SEGMENT

CLNK.CLNKTYPE

2

TYPE OF EVENT CONDITION IS LINKED TO

CRND.CRNDID

13

CRND ID KEY: CONDID + ROUND NUMBER

CRND.CRNDRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

CRND.CREATEQ

2

CREATION STAMP

IF SAME EPISODE OF CONDITION, SELECT ENTRY ON ROSTER.

IF NEW EPISODE OF CONDITION, ADD TO ROSTER.

[Medical Condition]

[Medical Condition]

[Medical Condition]

{BOX_02}

DISPLAY INSTRUCTIONS:

DISPLAY ‘visit’ IF OP02 IS CODED ‘1’ (SAW PROVIDER), ‘RF’

(REFUSED), OR ‘DK’ (DON’T KNOW) FOR THIS EVENT. DISPLAY

‘telephone call’ IF OP02 IS CODED ‘2’(TELEPHONE CALL) FOR THIS

EVENT.

PROGRAMMER NOTES:

DISPLAY 'ADD CONDITION' AS AN OPTION ON THIS SCREEN.

9

Beta

Outpatient Department (OP) Section

Title:

PERS_COND_1

Roster Details

Col #

Header

Instructions

1

MEDICAL CONDITION Display name of medical condition

COND.CONDNAM

Roster Behavior:

1. Multiple Select allowed.

2. Multiple Add allowed.

3. Limited Delete allowed. Interviewer may delete

a condition added on this screen as long as

CAPI has not yet created the link between this

condition and the event. If the interviewer

attempts to delete a condition when delete is

not allowed, display the following message:

“DELETE ALLOWED ONLY WHEN CONDITION

IS FIRST ENTERED.”

4. Limited Edit allowed. Interviewer may edit a

condition name newly added on this screen

as long as CAPI has not yet created the link

between this condition and the event. If the

interviewer attempts to edit a condition when

edit is not allowed, display the following

message: “EDIT ALLOWED ONLY WHEN

CONDITION IS FIRST ENTERED.”

Roster Filter:

Display all conditions on person’s roster; no filter.

Roster Definition:

Display the PERSON-MEDICAL-CONDITIONS-ROSTER for the selection

and addition of one or many medical condition(s) associated

with this event.

BOX_02

IF OP02 IS CODED '2' (TELEPHONE CALL), 'RF' (REFUSED), OR 'DK' (DON'T

KNOW), GO TO OP14.

IF OP02 IS CODED '1' (SAW PROVIDER), CONTINUE WITH BOX_03.

BOX_03

IF OP05 IS CODED '2' (DENTIST/DENTAL CARE PERSON), '3' (MIDWIFE), OR '5'

(OPTOMETRIST), GO TO OP11.

OTHERWISE, CONTINUE WITH OP10.

10

Beta

Outpatient Department (OP) Section

OP10

SHOW CARD OP-2.

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(TREATMENTSHELP)

Looking at this card, which of these treatments, if any, did (PERSON)

receive during this visit?

Size

Variable Name

Label

OPAT.OP10BLSWVS

OPAT.PHYSTH

2

THIS VISIT DID P HAVE PHYSICAL THERAPY

OPAT.OCCUPTH

2

THIS VST DID P HAVE OCCUPATIONAL THERAPY

OPAT.SPEECHTH

2

THIS VISIT DID P HAVE SPEECH THERAPY

OPAT.CHEMOTH

2

THIS VISIT DID P HAVE CHEMOTHERAPY

OPAT.RADIATTH

2

THIS VISIT DID P HAVE RADIATION THERAPY

OPAT.KIDNEYD

2

THIS VISIT DID P HAVE KIDNEY DIALYSIS

OPAT.IVTHER

2

THIS VISIT DID P HAVE IV THERAPY

OPAT.DRUGTRT

2

THIS VST DID P HAVE TRT FOR DRUG OR ALCH

OPAT.RCVSHOT

2

THIS VST DID P RECEIVE AN ALLERGY SHOT

OPAT.PSYCHOTH

2

DID P HAVE PSYCHOTHERAPY/COUNSELING?

CHECK ALL THAT APPLY.

1

PHYSICAL THERAPY

{OP11}

2

OCCUPATIONAL THERAPY

{OP11}

3

SPEECH THERAPY

{OP11}

4

CHEMOTHERAPY

{OP11}

5

RADIATION THERAPY

{OP11}

6

KIDNEY DIALYSIS

{OP11}

7

IV THERAPY

{OP11}

8

DRUG OR ALCOHOL TREATMENT

{OP11}

9

ALLERGY SHOT

{OP11}

10

PSYCHOTHERAPY/COUNSELING

{OP11}

95

NO TREATMENTS RECEIVED

{OP11}

RF

Refused

{OP11}

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

DK

Don't Know

{OP11}

HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.

11

Beta

Outpatient Department (OP) Section

PROGRAMMER NOTES:

ALLOW CODE ‘95’ (NO TREATMENTS), ‘RF’ (REFUSED), ‘DK’ (DON’T

KNOW) ALONE ONLY. THESE RESPONSES MAY NOT BE SELECTED WITH

ANY OTHER RESPONSE.

'NO TREATMENTS RECEIVED' IS NOT DISPLAYED ON SHOW CARD.

Hard CHECK:

EDIT: IF CODED ‘95’ (NO TREATMENTS RECEIVED), NO OTHER TREATMENT CATEGORIES

CAN BE CODED. IF INTERVIEWER SELECTS ANOTHER CODE WITH 'NO TREATMENTS',

DISPLAY THE FOLLOWING MESSAGE: ‘NO TREATMENTS RECEIVED CANNOT BE SELECTED

WITH OTHER OPTIONS. VERIFY AND RE-ENTER.'

12

Beta

Outpatient Department (OP) Section

OP11

SHOW CARD OP-3.

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(MEDSERVHELP)

Looking at this card, which of these services, if any, did (PERSON) have

during this visit?

Size

Variable Name

Label

OPAT.OP11BLSWVS

OPAT.LABTEST

2

THIS VISIT DID P HAVE LAB TESTS

OPAT.SONOGRAM

2

THIS VST DID P HAVE SONOGRAM OR ULTRASD

OPAT.XRAYS

2

THIS VISIT DID P HAVE XRAYS

OPAT.MAMMOG

2

THIS VISIT DID P HAVE A MAMMOGRAM

OPAT.MRI

2

DID PERSON HAVE AN MRI DURING THIS VISIT

OPAT.EKG

2

DID PERSON HAVE AN EKG OR ECG THIS VISIT

OPAT.EEG

2

DID PERSON HAVE AN EEG DURING THIS VISIT

OPAT.RCVVAC

2

THIS VISIT DID P RECEIVE A VACCINATION

OPAT.ANESTH

2

DURING THIS VISIT P RECEIVE ANESTHESIA

OPAT.OTHSVCE

2

DID P HAVE OTHER DIAG TESTS THIS VISIT

OPAT.THRTSWAB

2

CHECK ALL THAT APPLY.

1

LABORATORY TESTS

{OP12}

11

THROAT SWAB

{OP12}

2

SONOGRAM OR ULTRASOUND

{OP12}

3

X-RAYS

{OP12}

4

MAMMOGRAM

{OP12}

5

MRI OR CATSCAN

{OP12}

6

EKG OR ECG

{OP12}

7

EEG

{OP12}

8

VACCINATION

{OP12}

9

ANESTHESIA

{OP12}

10

OTHER DIAGNOSTIC TEST

{OP12}

95

NO SERVICES RECEIVED

{OP12}

RF

Refused

{OP12}

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

13

Beta

Outpatient Department (OP) Section

DK

Don't Know

{OP12}

HELP AVAILABLE FOR DEFINITIONS OF ANSWER CATEGORIES.

PROGRAMMER NOTES:

ALLOW CODE ‘4’ (MAMMOGRAM) ONLY IF PERSON IS FEMALE AND AGE IS

> 17 YEARS (OR AGE CATEGORIES 4 THROUGH 9).

ALLOW CODE '95' (NO SERVICES RECEIVED), 'RF' (REFUSED), 'DK'

(CON'T KNOW) AND ALONE ONLY. THESE RESPONSES MAY NOT BE

SELECTED WITH ANY OTHER RESPONSE.

'OTHER DIAGNOSTIC TEST' AND 'NO SERVICES RECEIVED' ARE NOT

DISPLAYED ON SHOW CARD.

Hard CHECK:

EDIT: IF CODED ‘95’ (NO SERVICES RECEIVED), NO OTHER TREATMENT CATEGORIES

CAN BE CODED. IF INTERVIEWER SELECTS ANOTHER CODE WITH 'NO SERVICES',

DISPLAY THE FOLLOWING MESSAGE: ‘NO SERVICES RECEIVED CANNOT BE SELECTED

WITH OTHER OPTIONS. VERIFY AND RE-ENTER.'

OP12

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(SURGPROCHELP)

Was a surgical procedure performed on (PERSON) during this visit?

Size

Variable Name

Label

OPAT.SURGPROC

2

WAS SURG PROC PERFORMED ON P THIS VISIT

1

YES

{OP14}

2

NO

{OP14}

RF

Refused

{OP14}

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

DK

Don't Know

{OP14}

HELP AVAILABLE FOR DEFINITION OF SURGICAL PROCEDURE.

14

Beta

Outpatient Department (OP) Section

OP14

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(MEDPRESHELP)

During this {visit/telephone call}, were any medicines prescribed for

(PERSON)? Please include only prescriptions which were filled.

Size

Variable Name

Label

OPAT.MEDPRESC

2

ANY MEDICINS PRESCRIBED FOR P THIS VISIT

1

YES

{OP15}

2

NO

{BOX_04}

RF

Refused

{BOX_04}

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

DK

Don't Know

{BOX_04}

HELP AVAILABLE FOR DEFINITION OF PRESCRIBED MEDICINE.

DISPLAY INSTRUCTIONS:

DISPLAY ‘visit’ IF OP02 IS CODED ‘1’ (SAW PROVIDER), ‘RF’

(REFUSED), OR ‘DK’ (DON’T KNOW) FOR THIS EVENT. DISPLAY

‘telephone call’ IF OP02 IS CODED ‘2’(TELEPHONE CALL) FOR THIS

EVENT.

15

Beta

Outpatient Department (OP) Section

OP15

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

Please tell me the names of the prescriptions from this visit that were filled.

PROBE: Any other prescribed medicines from this visit that were filled?

Size

Variable Name

Label

PMED.PMEDID

12

PMED ID KEY: PERSID + COUNTER(3) + CD

PMED.PMEDRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

PMED.CREATEQ

4

QUESTION THAT CREATED PMED SEGMENT

PMED.PMEDNAME

30

NAME OF MEDS AND PRESCRIPTIONS FILLED

PMED.DRUGLINK

3

LINKS PMED TO DRUGID

PMED.STOREVAR

2

MATRIX TEMPORARY STORAGE VARIABLE

RXLK.RXLKID

24

RXLK ID KEY: EVENTID + PMEDID

RXLK.RXLKRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

RXLK.CREATEQ

4

QUESTION THAT CREATED RXLK RECORD

EVNT.EVNTID

12

EVNT ID KEY: PERSID + COUNTER(3) + CD

EVNT.EVNTRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

EVNT.CREATEQ

5

QUESTION THAT CREATED EVNT SEGMENT

EVNT.EVNTTYPE

2

EVENT TYPE

EVPV.EVPVID

23

EVPV ID KEY: EVNTID + PROVID

EVPV.EVPVRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

EVPV.CREATEQ

5

QUESTION THAT CREATED EVPV SEGMENT

EVPV.EVNTTYPE

2

EVENT TYPE

EVPV.EVPVTYPE

2

PROVIDER TYPE RELATED TO EVENT

DRUG.DRUGID

11

DRUG ID KEY: PERSID + COUNTER(3)

DRUG.DRUGRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

DRUG.CREATEQ

4

QUESTION THAT CREATED DRUG SEGMENT

DRUG.DRUGNAME

30

NAME OF MEDS AND PRESCRIPTIONS FILLED

DRUG.STOREVAR

2

MATRIX TEMPORARY STORAGE VARIABLE

[Prescribed Medicine]

[Prescribed Medicine]

[Prescribed Medicine]

{BOX_04}

PROGRAMMER NOTES:

DISPLAY 'ADD MEDICINE' AS AN OPTION ON THIS SCREEN.

16

Beta

Outpatient Department (OP) Section

Title:

PERSON'S_PRESCRIBED-MEDICINES_1

Roster Details

Col #

Header

Instructions

1

PRESCRIBED

MEDICINE

Display name of prescribed medicine

DRUG.DRUGNAME

Roster Behavior:

1. Multiple select allowed and add allowed.

2. Limited delete allowed. Interviewer may

delete a PMED added on this screen as long

as CAPI has not yet created the link between

this PMED and the event. If the interviewer

attempts to delete a PMED name when delete

is not allowed, display the following error

message: "DELETE ALLOWED ONLY WHEN

MEDICINE IS FIRST ENTERED."

3. Limited edit allowed. Interviewer may edit

the name of a PMED added on this screen

as long as CAPI has not yet created the link

between this PMED and the event. If the

interviewer attempts to edit a PMED name

when editing is not allowed, display the

following message: "EDITING ALLOWED

ONLY WHEN MEDICINE IS FIRST ENTERED."

Roster Filter:

Display all medicines on person's roster; no filter.

Roster Definition:

This item displays the PERSON’S-PRESCRIPTION-MEDICINES-ROSTER

for selection and addition of prescribed medicines.

BOX_04

IF OP02 IS CODED '2' (TELEPHONE CALL), 'RF' (REFUSED), OR 'DK' (DON'T

KNOW), GO TO BOX_10.

IF OP02 IS CODED '1' (SAW PROVIDER), GO TO BOX_07.

BOX_07

IF NO CONDITION IS ASSOCIATED WITH THIS VISIT TO THIS PROVIDER FOR THIS

PERSON, GO TO BOX_10.

OTHERWISE, CONTINUE WITH BOX_08.

17

Beta

Outpatient Department (OP) Section

BOX_08

IF 2 OR MORE VISITS TO THIS PROVIDER FOR THIS PERSON HAVE NOT COMPLETED

THE OUTPATIENT DEPARTMENT (OP) UTILIZATION SECTION, CONTINUE WITH BOX_09.

OTHERWISE, GO TO BOX_10.

BOX_09

IF THIS EVENT IS NOT PART OF A FLAT FEE GROUP, CONTINUE WITH OP19.

OTHERWISE, GO TO BOX_10.

18

Beta

Outpatient Department (OP) Section

OP19

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(REPEATVSTHELP)

Earlier I recorded that (PERSON) had some other visits to an outpatient

department at (PROVIDER). Were any of these visits related to any condition

associated with (PERSON)’s visit on (VISIT DATE)? That is, were any of the

other visits for the (READ CONDITIONS BELOW) and did (PERSON) receive

{(READ SERVICES BELOW)/the same services}?

CONDITIONS

SERVICES

{PERSON'S OP MEDICAL CONDITIONS}

{SERVICES RECEIVED}

{PERSON'S OP MEDICAL CONDITIONS}

{SERVICES RECEIVED}

{PERSON'S OP MEDICAL CONDITIONS}

{SERVICES RECEIVED}

Size

Variable Name

Label

OPAT.SAMECOND

2

ANY OTH VST FOR SAME COND, SAME SERVICES

1

YES

{OP20}

2

NO

{BOX_10}

RF

Refused

{BOX_10}

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

DK

Don't Know

{BOX_10}

HELP AVAILABLE FOR DEFINITION OF REPEAT VISITS.

19

Beta

Outpatient Department (OP) Section

DISPLAY INSTRUCTIONS:

DISPLAY ‘(READ SERVICES BELOW)’ IF OP11 IS NOT CODED ‘95’ (NO

SERVICES RECEIVED), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW). IF

OP11 IS CODED ‘95’ (NO SERVICES RECEIVED), ‘RF’ (REFUSED), OR

‘DK’ (DON’T KNOW), DISPLAY ‘the same services’.

FOR ‘PERSON’S OP MEDICAL CONDITION’, DISPLAY ALL CONDITIONS

SELECTED FROM OR ADDED TO PERSON’S-MEDICAL-CONDITIONS-ROSTER

AT OP09.

FOR ‘SERVICES RECEIVED’, DISPLAY THE FOLLOWING TEXT FOR EACH

SERVICE SELECTED AT OP11:

CODE ‘1’ = LABORATORY TESTS

CODE ‘2’ = SONOGRAM/ULTRASOUND

CODE ‘3’ = X-RAYS

CODE ‘4’ = MAMMOGRAM

CODE ‘5’ = MRI/CATSCAN

CODE ‘6’ = EKG/ECG

CODE ‘7’ = EEG

CODE ‘8’ = VACCINATION

CODE ‘9’ = ANESTHESIA

CODE ‘10’ = OTHER SERVICES

CODE '11' = THROAT SWAB

20

Beta

Outpatient Department (OP) Section

OP20

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

(SAMEAMTHELP)

Did any of these visits or calls cost the same amount as (PERSON)’s visit on

(VISIT DATE)?

Size

Variable Name

Label

OPAT.SAMEAMT

2

ANY SIM VISITS COST SAME AMT AS THIS VST

1

YES

{OP21}

2

NO

{BOX_10}

RF

Refused

{BOX_10}

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

DK

Don't Know

{BOX_10}

HELP AVAILABLE FOR DEFINITION OF COST THE SAME AMOUNT.

PROGRAMMER NOTES:

THE ISSUE OF COST WHEN THE PERSON HAS A COPAY AND DOES NOT

KNOW THE TOTAL CHARGE WILL BE HANDLED IN THE HELP FILE

DEFINITION.

21

Beta

Outpatient Department (OP) Section

OP21

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

Which of the following visits were related to the (READ CONDITIONS

BELOW) and {(READ SERVICES BELOW)/the same services} and cost the

same amount as the (VISIT DATE) visit we’ve just talked about?

PROBE: Any other visits related to this condition and cost the same amount?

CONDITIONS

SERVICES

{PERSON'S OP MEDICAL CONDITIONS}

{SERVICES RECEIVED}

{PERSON'S OP MEDICAL CONDITIONS}

{SERVICES RECEIVED}

{PERSON'S OP MEDICAL CONDITIONS}

{SERVICES RECEIVED}

Size

Variable Name

Label

EVNT.RVTYPE

2

REPEAT VISIT TYPE - STEM/LEAF

EVNT.RVSTEM

4

4-DIGIT EVENT NUMBER OF STEM RV

EVNT.PROCFLAG

2

EVNT UTILIZATION PROCESS FLAG

CLNK.CLNKID

24

CLNK ID KEY: CONDID + EVNTID

CLNK.CLNKRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

CLNK.CREATEQ

4

QUESTION THAT CREATED CLNK SEGMENT

CLNK.CLNKTYPE

2

TYPE OF EVENT CONDITION IS LINKED TO

EVPV.RVTYPE

2

REPEAT VISIT TYPE - STEM/LEAF

EVPV.RVSTEM

4

4-DIGIT EVENT NUMBER OF STEM RV

EVPV.CPFLAG

2

CHARGE PAYMENT PROCESS FLAG

OPAT.OPATID

12

OPAT ID KEY: PERSID + COUNTER(3) + CD

OPAT.OPATRURN

2

ROUND STAMP: RU LETTER + ROUND NUMBER

OPAT.CREATEQ

2

CREATION STAMP

[Month,Day,Year]

[Month,Day,Year]

[Month,Day,Year]

{OP22}

22

Beta

Outpatient Department (OP) Section

DISPLAY INSTRUCTIONS:

DISPLAY ‘(READ SERVICES BELOW)’ IF OP11 IS NOT CODED ‘95’ (NO

SERVICES RECEIVED), ‘RF’ (REFUSED), OR ‘DK’ (DON’T KNOW). IF

OP11 IS CODED ‘95’ (NO SERVICES RECEIVED), ‘RF’ (REFUSED), OR

‘DK’ (DON’T KNOW), DISPLAY ‘the same services’.

FOR ‘PERSON’S OP MEDICAL CONDITIONS’, DISPLAY ALL CONDITIONS

SELECTED FROM OR ADDED TO PERSON’S-MEDICAL-CONDITIONS-ROSTER

AT OP09.

FOR ‘SERVICES RECEIVED’, DISPLAY THE FOLLOWING TEXT FOR EACH

SERVICE SELECTED AT OP11:

CODE ‘1’ = LABORATORY TESTS

CODE ‘2’ = SONOGRAM/ULTRASOUND

CODE ‘3’ = X-RAY

CODE ‘4’ = MAMMOGRAM

CODE ‘5’ = MRI/CATSCAN

CODE ‘6’ = EKG/ECG

CODE ‘7’ = EEG

CODE ‘8’ = VACCINATION

CODE ‘9’ = ANESTHESIA

CODE ‘10’ = OTHER SERVICES

CODE '11' = THROAT SWAB

PROGRAMMER NOTES:

FLAG EACH VISIT SELECTED AT OP21 AS A REPEAT VISIT RELATED TO

THE EVENT BEING ASKED ABOUT.

FLAG THE CHARGE PAYMENT (CP) STATUS OF EACH REPEAT VISIT AS

'PROCESSED'.

LINK CONDITION(S) AND SERVICE(S) ASSOCIATED WITH THE EVENT

BEING ASKED ABOUT WITH EACH REPEAT VISIT.

THE EVENT DRIVER WILL NOT SERVE THESE REPEAT VISITS FOR THE OP

SECTION.

Title:

PERS_EVNT_1

Roster Details

Col #

Header

Instructions

1

MONTH/DAY/YEAR

Display Event Begin Date

EVNT.EVNTBEGM

EVNT.EVNTBEGD

EVNT.EVNTBEGY

Roster Behavior:

1. Multiple select allowed.

Roster Definition:

This item displays all medical events (dates) on person’s-

medical-events-roster for selection.

23

Beta

Outpatient Department (OP) Section

2. Add, delete, and edit disallowed.

Roster Filter:

Display only those events with the following

characteristics:

1. Event was created this round.

2. Event has not been processed in utilization.

3. Event has event type ‘OP’.

4. Event is associated with the same provider

as the event being asked about.

OP22

{PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} {EVN-DT}

Comment Enabled

Jump Back Enabled

Help Enabled

Size

Variable Name

Label

EVNT.RVNAME

30

NAME OF REPEAT VISIT GROUP

EVPV.RVNAME

30

NAME OF REPEAT VISIT GROUP

INTERVIEWER: RECORD ‘NAME OF REPEAT VISIT GROUP’ FOR

EVENTS SELECTED IN PREVIOUS QUESTION:

{BOX_10}

NAME: _______________________

24

Beta

Outpatient Department (OP) Section

BOX_10

IF CHARGE/PAYMENT (CP) SECTION IS NOT COMPLETED FOR THIS OUTPATIENT EVENT,

ASK THE CHARGE/PAYMENT (CP) SECTION.

OTHERWISE, GO TO EVENT DRIVER (ED) SECTION.

25

File Typeapplication/pdf
File Title\\rk29\vol2905\MEPSWVS\SpecWriter\BETA\op (beta).snp
Authormiller_n
File Modified2005-12-21
File Created2005-12-21

© 2024 OMB.report | Privacy Policy