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pdfMCBS Blaise/WVS
CE. Restart
Clicking on the BREAKOFF link in the Blaise/WVS instrument allows the interviewer to stop
the interview prior to completing it through the Closing section. BREAKOFF is allowed at every
screen in the instrument except in the following sections: IN, ENS, EN, and CL/AV. When the
BREAKOFF link is selected, the program routes to a closing screen where the interviewer can
assign the appropriate interim disposition code. The variable MRES.EVRESTRT is set to
“1/Yes”.
When the interview is restarted, the instrument first goes to screen IN2, where the SP’s name is
verified. Screen CE1 is displayed next and provides the interviewer with detailed information
about when and where the BREAKOFF occurred. The interview is finally routed to one of the
screens listed in BOX CE1.
Review screens are presented during a restart interview when the breakoff occurred either in the
HI section, any of the utilization sections (except UTS), or the ST section. These screens are
similar to those that an interviewer can currently view using the CTRL/I function in Cheshire.
After reviewing the CE screens, the interviewer is instructed to click on the “JUMPBACK” link
to return to the appropriate place in the interview.
BOX CEBEG
1
CE1 (replaces IN3A - OKRESTRT)
Question display:
Display date of most recent breakoff.
If SP is the respondent, display SP' s name.
Else display Proxy's name.
If MRES.SPALIVE = 1/Alive, display SP's status as "ALIVE AND NOT
INSTITUTIONALIZED".
Else if MRES.SPALIVE = 2/AliveAndInstitute, display SP's status as "INSTITUTIONALIZED".
Else if MRES.SPALIVE = 3/Deceased, display SP's status as "DECEASED - DIED IN THE
COMMUNITY".
Display Section name in all caps where breakoff occurred. See general specifications for Section
Names.
Int. Instr. I:
A PORTION OF THIS INTERVIEW WAS COMPLETED ON (DATE OF MOST RECENT
BREAKOFF). THE RESPONDENT FOR THAT INTERVIEW WAS (RESPONDENT NAME).
AT THAT TIME, THE SP WAS (ALIVE AND NOT
INSTITUTIONALIZED/INSTITUTIONALIZED/DECEASED - DIED IN THE
COMMUNITY).
THE INTERVIEW WAS BROKEN OFF IN THE (SECTION NAME). TODAY'S
INTERVIEW WILL START WHERE THE BREAKOFF OCCURRED.
DO YOU WANT TO CONTINUE?
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BOX CE1
IF IN3A - OKRESTRT =2/No, THEN GO TO IMS.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE HA
SECTION, GO TO BOX HA1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE HIS
SECTION, GO TO HISINTRO.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE HI
SECTION, GO TO CE2.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE DM
SECTION, GO TO BOX DM1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE UTS
SECTION, GO TO UTS1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE DU
SECTION, THE ER SECTION, THE IP SECTION, THE OP SECTION, THE IU SECTION,
THE HHS SECTION, THE HH SECTION, THE MP SECTION, THE OM SECTION, THE
PMS SECTION OR THE PM SECTION, GO TO CE3.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE ST
SECTION, GO TO CE7 (replaces ST3 – MCSAVAIL).
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE NS
SECTION, GO TO BOX NSBEG.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE CPS
SECTION, GO TO BOX CPSBEG.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE IA
SECTION, GO TO BOX IA1A.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE PD
SECTION, GO TO PD1 OR PDINTRO.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE RX
SECTION, GO TO RX1 OR RXINTRO.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE KN
SECTION, GO TO KNINTRO.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE HF
SECTION, GO TO HFA1, HFFINTRO, HFHINTRO, HFJINTRO, HFKINTRO, HFLINTRO,
HFM1, HFPINTRO, HFSINTRO, AC29, OR HFT1.
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ELSE IF THE SP IS IN THE SUPPLEMENTAL SAMPLE AND THIS IS A RESTART
INTERVIEW, AND BREAKOFF OCCURRED IN THE AC SECTION, GO TO BOX AC1AA.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE US
SECTION, GO TO US1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE SC
SECTION, GO TO SC1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE DI
SECTION, GO TO DIINTROA.
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CE2
Report display: Display report below Question Text.
Display all insurance plans SP reported being covered by in the current round. First, display
MEDICARE MANAGED CARE PLANS (MHMO) name if SP has MHMO, or MEDICARE if
no MHMO. Next list Medicaid, Tricare, Public Plans and Private Plans. If there is more than one
Public Plan, display the Public Plans in order of entry. If there is more than one Private Plan,
display the Private Plans in order of entry.
Report Header: HEALTH INSURANCE PLANS REPORTED FOR (SP) THIS ROUND
Column 1, Header="Plan Name", display PLAN.PLNAME.
Column 2, Header="Plan Type", display PLAN.PLANTYPE:
If PLANTYPE=1/Medicare, display "(MCAR)".
If PLANTYPE=2/Medicaid, display "(MCAD)".
If PLANTYPE=3/PublicPlan, display "(PUBL)".
If PLANTYPE=4/PrivatePlan, display "(PRIV)".
If PLANTYPE=5/MHMO, display "(MHMO)".
If PLANTYPE=6/Tricare, display "(TRIC)".
Int. Instr. I:
THE INTERVIEW WAS BROKEN OFF IN THE (SECTION NAME) SECTION.
Question text:
THE FOLLOWING HEALTH INSURANCE PLANS HAVE BEEN ENTERED FOR (SP) THIS
ROUND. PLEASE REVIEW BEFORE RESTARTING THE INTERVIEW.
[GO TO BOX MC1AA.]
5
CE3
Report display: Display report below Question Text.
Display all events where:
EVNT.EVNTTYPE = 'DU', 'ER', 'IP', 'IU', 'OP', 'MP', 'SD', or 'SL', and
EVNT.EVNTRNDC = (Current Round) and
EVNT.EVNTDFLG ^= 1/Yes
Display in order of entry.
Report Header: PROVIDER SERVICE DATES REPORTED FOR (SP) THIS ROUND
Column 1, Header = "Provider Name".
Column 1, Display =
Display PROV.PROVNAME
Column 2, Header = "Type".
Column 2, Display =
Display EVNT.EVNTTYPE
Column 3, Header = "Start Date".
Column 3, Display =
Display EVENT DATE in "Mon DD YYYY" format.
Column 4, Header = "Stop Date".
Column 4, Display =
If (EVNT.EVNTTYPE = 'IU') or (EVNT.EVNTTYPE = 'IP' and
EVNT.IPSTATUS ^= 1/StillInHospital), display EVENT END DATE in
"Mon DD YYYY" format.
Else do not display.
Column 5, Header = "Status".
Column 5, Display =
If EVNT.EVNTTYPE = 'IP' and EVNT.IPSTATUS = 1/StillInHospital,
display "ON".
Else if EVNT.VISTTYPE = 2/RepeatVisit, display "RV".
Else do not display.
Column 6, Header = "# Visits".
Column 6, Display =
If EVNT.VISTTYPE = 2/RepeatVisit, display EVNT.RVTIMES.
Else do not display.
Question display: Display Int. Instr. II if this is a restart interview and the breakoff occurred in
the HH section, the MP section, the OM section, the PMS section or the PM section. Else, do not
display.
6
Int. Instr. I:
THE INTERVIEW WAS BROKEN OFF IN THE (SECTION NAME) SECTION.
Question text:
THE FOLLOWING PROVIDER SERVICE DATES HAVE BEEN ENTERED FOR (SP) THIS
ROUND. PLEASE REVIEW BEFORE RESTARTING THE INTERVIEW.
Int. Instr. II:
(CLICK “NEXT PAGE” TO REVIEW OTHER EVENTS ENTERED FOR THIS ROUND.)
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BOX CE2
IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE DU
SECTION, GO TO DUINTRO.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE ER
SECTION, GO TO ER1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE IP
SECTION, GO TO BOX IP1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE OP
SECTION, GO TO OP1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE IU
SECTION, GO TO IU1.
ELSE IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE HHS
SECTION, GO TO BOX HHS1.
ELSE GO TO CE4.
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CE4
Report display: Display report below Question Text.
Display all events where:
EVNT.EVNTTYPE = 'HP' or 'HF', and
EVNT.EVNTRNDC = (Current Round) and
EVNT.EVNTDFLG ^= 1/Yes
Display in order of entry.
Report Header: HOME HEALTH VISITS REPORTED FOR (SP) THIS ROUND
Column 1, Header = "Provider Name".
Column 1, Display =
Display PROV.PROVNAME
Column 2, Header = "Type".
Column 2, Display =
Display EVNT.EVNTTYPE
Question display: Display Int. Instr. II if this is a restart interview and breakoff occurred in the
OM section, the PMS section or the PM section.
Int. Instr. I:
THE INTERVIEW WAS BROKEN OFF IN THE (SECTION NAME) SECTION.
Question text:
THE FOLLOWING HOME HEALTH VISITS HAVE BEEN ENTERED FOR (SP) THIS
ROUND. PLEASE REVIEW BEFORE RESTARTING THE INTERVIEW.
Int. Instr. II:
(CLICK “NEXT PAGE” TO REVIEW OTHER EVENTS ENTERED FOR THIS ROUND.)
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BOX CE3
IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE HH
SECTION, GO TO HH1.
ELSE GO TO CE5.
10
CE5
Report display: Display report below Question Text.
Display all other medical expense items where:
EVNT.EVNTTYPE = OM and
EVNT.EVNTRNDC = (Current Round) and
EVNT.EVNTDFLG^=1/Yes.
Display in order of entry.
Report Header = OTHER MEDICAL EXPENSES REPORTED FOR (SP) THIS ROUND
Column 1, Display =
If EVNT.RENTPROB=2/Rent and EVNT.RENT2BUY ^=
2/PurchasedRentToBuy, display "R".
Else do not display.
Column 2, Header = "OME Type".
Column 2, Display =
If EVNT.STOMTYPE = 91/Other, display Other Specify Text,
EVOS.EVOSTEXT, on EVOS where EVOS.EVOSEVNT = this
EVNT.EVNTNUM.
Else display EVNT.STOMTYPE response text.
Column 3, Header =
"Purchase or Repair/Rental Date".
Column 3, Display =
If (EVNT.OTHRTYPE ^= 5/OstomySupplies and EVNT.OTHRTYPE
^= 6/IncontinenceSupplies and EVNT.OTHRTYPE ^= 7/Bandages)
and (EVNT.OMSTATUS ^= 1/AlterationNotComplete), display EVNT
DATE in "Mon DD YYYY" format.
Else do not display.
Column 4, Header =
"Rental Stop Date".
Column 4, Display =
If (EVNT.RENTSTIL = 2/No, DK, or RF) and (EVNT.RENT2BUY ^=
2/PurchasedRentToBuy), display EVNT END DATE in "Mon DD
YYYY" format.
Else do not display.
Column 5, Header = "Status".
Column 5, Display =
If EVNT.OMSTATUS = 1/AlterationNotComplete, display "ON".
Else if EVNT.RENTSTIL = 1/Yes, display "RR".
Else if EVNT.RENT2BUY = 2/PurchasedRentToBuy, display "OW".
Else do not display.
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Question display: Display Int. Instr. II if this is a restart interview and breakoff occurred in the
PM section. Else, do not display.
Int. Instr. I:
THE INTERVIEW WAS BROKEN OFF IN THE (SECTION NAME) SECTION.
Question text:
THE FOLLOWING OTHER MEDICAL EXPENSE ITEMS HAVE BEEN ENTERED FOR
(SP) THIS ROUND. PLEASE REVIEW BEFORE RESTARTING THE INTERVIEW.
Int. Instr. II:
(CLICK “NEXT PAGE” TO REVIEW OTHER EVENTS ENTERED FOR THIS ROUND.)
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BOX CE4
IF THIS IS A RESTART INTERVIEW AND BREAKOFF OCCURRED IN THE OM
SECTION, GO TO OM1.
ELSE IF THIS IS A RESTART INTERVIEW AND THE BREAKOFF OCCURRED IN THE
PMS SECTION, GO TO BOX PMS1.
ELSE GO TO CE6.
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CE6
Report display: Display report below Question Text.
Display all Prescription Medicine events where:
EVNT.EVNTTYPE='PM'
EVNT.EVNTRNDC = (Current Round) and
EVNT.EVNTDFLG ^=1/Yes.
Display in alphabetical order.
Report Header = PRESCRIBED MEDICINES REPORTED FOR (SP) THIS ROUND
Column 1, Header = "Medicine".
Column 1, Display =
Display prescription medicine name,
EVNT.PMEDNAME.
Column 2, Header = "# Purchases".
Column 2, Display =
Display PMRO.GETNUM.
Int. Instr. I:
THE INTERVIEW WAS BROKEN OFF IN THE (SECTION NAME) SECTION.
Question text:
THE FOLLOWING PRESCRIBED MEDICINES HAVE BEEN ENTERED FOR (SP) THIS
ROUND. PLEASE REVIEW BEFORE RESTARTING THE INTERVIEW.
[GO TO PMINTROA.]
14
CE7
Report display:
Display report below question text.
Display Medicare claim control number, insurance claim control number, and TRICARE claim
control number for all charge bundles previously entered for the current round interview. See
detailed instructions below.
Report Header: CLAIM NUMBERS ENTERED THIS ROUND
Column 1, header = "MSN".
Column 1, display = If COST.STATTYPE = 1/Medicare, 3/MedicareAndInsurance,
5/MedicareAndTricare, or 7/MedicareAndTricareAndInsurance, display "(MSN CLAIM
CONTROL NUMBER)". Else display "NONE".
Column 2, header = "INSURANCE":
Column 2, display = If COST.STATTYPE = 2/Insurance, 3/MedicareAndInsurance,
6/TricareAndInsurance, or 7/MedicareAndTricareAndInsurance, display "(INSURANCE CLAIM
CONTROL NUMBER)". Else display "NONE".
Column 3, header = "TRICARE":
Column 3, display = If COST.STATTYPE = 4/Tricare, 5/MedicareAndTricare,
6/TricareAndInsurance, or 7/MedicareAndTricareAndInsurance, display "(TRICARE CLAIM
CONTROL NUMBER)". Else display "NONE".
Int. Instr. I:
THE INTERVIEW WAS BROKEN OFF IN THE (SECTION NAME) SECTION.
Question text:
YOU HAVE ENTERED THE FOLLOWING CLAIM CONTROL NUMBERS FOR THIS
ROUND.
[GO TO BOX STBEG]
BOX CEEND
15
| File Type | application/pdf |
| Author | hubbard_r |
| File Modified | 2010-03-30 |
| File Created | 0000-00-00 |