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pdfBOX IP1
BOX IP1
Page Order # :
10
BOX INSTRUCTIONS
( IPQ1010 )
IF THE SP WAS STILL IN A HOSPTIAL AT THE TIME OF THE PREVIOUS
ROUND INTERVIEW, GO TO IPS1 - EVENDMM ( IPQ1011 ).
ELSE IF SP IS IN THE EXIT SAMPLE AND PREVIOUS ROUND INTERVIEW
WAS NOT SKIPPED, GO TO BOX IP6 - (IPQ1400 ).
ELSE GO TO BOX IP1AB - (IPQ1016 ).
ASSIGNMENTS
TECHNICAL NOTES
137
SPStillInHospPrevRnd
SP was still in a hospital at the time of the previous round
interview =
There is an EVNT where EVNT.EVNTDFLG^=1/Yes and
EVNT.EVNTTYPE='IP' and
EVNT.IPSTATUS=1/StillInHospital.
19
ExitNotSkip
If SP is in the Exit Sample and previous round interview
not skipped =
MRES.INTTYPE=8/ExitInterviewHadPrev on MRES
where MRES.MRESRND = current round.
DESIGN NOTES
If SP is in the exit sample and previous round interview was not skipped,
MRES.INTTYPE=8/ExitInterviewHadPrev, we are only interested in
collecting data for an on-going IP stay from the previous round, if it exists.
If the SP had an on-going IP visit from the previous round (there is an IP
event where EVNT.IPStatus=1/StillInHospital), BOX IP1 is routed to IPS1
to probe for the end date. If the on-going IP stay does not exist, we do not
probe for new IP visits. Instead, BOX IP1 is routed to the end of IP.
9:55:25 AM Friday, March 06, 2009
Page 1 of 79
IPS1
IPS1
Page Order # :
Design Screen Type:
Date
Fields:
Field 1:
EVENDMM
Field 2:
EVENDDD
Field 3:
EVENDYY
Field 4:
STILLHOSP
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
Enable Functions:
12
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display the name of the hospital, PROV.PROVNAME, for the
Inpatient stay from the previous round.
Display admission date,
EVNT.EVBEGMM/EVNT.EVBEGDD/EVNT.EVBEGYY.
(were/was):
If proxy interview, display "was".
Else display "were".
Multi Field display:
Vertical Alignment
Display Discharge date input fields, EVENDMM, EVENDDD,
EVENDYY, on 1st line.
Display radio button for "SP STILL IN HOSPITAL", IPS1
STILLHOSP, on 2nd line.
Roster/Grid Instructions:
Roster/Grid display:
Report display:
9:55:27 AM Friday, March 06, 2009
Page 2 of 79
IPS1
TEXT:
Context Header:
Int. Instr I:
Last time [you/(SP)] had been admitted to (HOSPITAL NAME) on
(ADMISSION DATE) and (were/was) still a patient there on
(REFERENCE DATE). When [were you/was (SP)] discharged from
(HOSPITAL NAME) for that stay?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
EVENDMM
Field1:
Cheshire Name:
( IPQ1011 )
EVNT.EVENDMM
Item Text display:
Item Text:
Label:
Label Position:
MM
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TMonthIntEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IPS1 - EVENDDD ( IPQ1012 )
Don't know
IPS1 - EVENDDD ( IPQ1012 )
Refusal
IPS1 - EVENDDD ( IPQ1012 )
9:55:30 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
01
12
Route
IPS1 - EVENDDD ( IPQ1012 )
Page 3 of 79
IPS1
EVENDDD
Field2:
Cheshire Name:
( IPQ1012 )
EVNT.EVENDDD
Item Text display:
Item Text:
Label:
Label Position:
DD
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TDayDKRFEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IPS1 - EVENDYY ( IPQ1013 )
Don't know
IPS1 - EVENDYY ( IPQ1013 )
Refusal
IPS1 - EVENDYY ( IPQ1013 )
9:55:34 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
1
31
Route
IPS1 - EVENDYY ( IPQ1013 )
Page 4 of 79
IPS1
EVENDYY
Field3:
Cheshire Name:
( IPQ1013 )
EVNT.EVENDYY
Item Text display:
Item Text:
Label:
Label Position:
YY
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TYear2DKRFEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IPS1 - STILLHOSP ( IPQ1014 )
Don't know
IPS1 - STILLHOSP ( IPQ1014 )
Refusal
IPS1 - STILLHOSP ( IPQ1014 )
9:55:38 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
00
99
Route
IPS1 - STILLHOSP ( IPQ1014 )
Page 5 of 79
IPS1
STILLHOSP
Field4:
Cheshire Name:
( IPQ1014 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TStillHosp
1
No
No
Number Label
1 StillInHosptial
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX IP1A - (IPQ1015 )
English text: SP IS STILL IN HOSPITAL
Attribute
Empty
Route
BOX IP1A - (IPQ1015 )
BACKGROUND VARIABLE ASSIGNMENTS
If SP is no longer in the hospital and a discharge date is entered at IPS1, set last round
when SP was still in hospital and update IP status to "discharged".
See detailed instructions below:
EV95FLG
EVNT.EV95FLG = previous round.
IPSTATUS
EVNT.IPSTATUS = 2/Discharged.
SOFT EDIT CHECKS
Edit #1
Discharge date, EVENDMM/EVENDDD/EVENDYY, should be on or
after (REFERENCE DATE).
If not true, then display message: "VERIFY THAT SP WAS
DISCHARGED ON OR BEFORE (REFERENCE DATE)".
HARD EDIT CHECKS
Edit #1:
If SP is deceased or institutionalized, then STILLHOSP should be
empty.
If not true, display message "PLEASE ENTER DISCHARGE DATE."
Edit #2:
Discharge date, EVENDMM,/EVENDDD/EVENDYY, and
STILLHOSP cannot both be EMPTY.
If not true, display message "PLEASE ENTER DISCHARGE DATE
OR SELECT "SP IS STILL IN HOSPITAL"."
9:55:40 AM Friday, March 06, 2009
Page 6 of 79
IPS1
Edit #3:
Discharge date, EVENDMM/EVENDDD/EVENDYY, and
STILLHOSP cannot both be filled.
If not true, display message "PLEASE ENTER DISCHARGE DATE
OR SELECT "SP IS STILL IN HOSPITAL"."
Edit #4:
Discharge Date, EVENDMM/EVENDDD/EVENDYY must be on or
before (TODAY/DATE OF DEATH/DATE OF
INSTITUTIONALIZATION).
If not true, display message: "INVALID DATE. DISCHARGE DATE
MUST BE ON OR BEFORE (TODAY/DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)".
Edit #5:
Discharge Date, EVENDMM/EVENDDD/EVENDYY, must on or after
the (ADMISSION DATE).
If not true, display message: "INVALID DATE. DATE MUST BE ON
OR AFTER (ADMISSION DATE)".
TECHNICAL NOTES
DESIGN NOTES
IPS1 is asked for an existing Inpatient Stay where the SP was reported as
"still in the hospital" at the time of the previous round interview. IPS1
determines if the SP is still in the hospital or has been discharged at the
time of the current round interview. There can only be one "on-going" IP
stay from the previous round. If the SP is still in the hospital at the time of
the current round interview, we do not probe for additional IP stays in the
current round.
9:55:40 AM Friday, March 06, 2009
Page 7 of 79
BOX IP1A
BOX IP1A
Page Order # :
14
BOX INSTRUCTIONS
( IPQ1015 )
IF SP WAS REPORTED AS STILL IN THE HOSPITAL AT IPS1, GO TO BOX
IP6 - (IPQ1400 ).
ELSE GO TO IP7 - ANYOPERS ( IPQ1240 ).
ASSIGNMENTS
TECHNICAL NOTES
140
SPStillInHosp
SP was reported as still in the hospital (in current round) =
For this EVNT, EVNT.IPSTATUS=1/StillInHospital.
DESIGN NOTES
9:55:40 AM Friday, March 06, 2009
Page 8 of 79
BOX IP1AB
BOX IP1AB
Page Order # :
15
BOX INSTRUCTIONS
( IPQ1016 )
IF THE SP HAD AT LEAST ONE EMERGENCY ROOM VISIT IN THE
CURRENT ROUND THAT RESULTED IN THE SP BEING ADMITTED TO A
HOSPITAL, GO TO BOX IP1AA - (IPQ1017 ).
ELSE GO TO IP1 - IPPROBE ( IPQ1025 ).
ASSIGNMENTS
TECHNICAL NOTES
138
ERtoIPStay
SP had an emergency room visit in the current round that
resulted in the SP being admitted to hospital =
There is an EVNT where EVNT.EVNTDFLG^=1/Yes and
EVNT.EVNTRNDC=current round and
EVNT.EVNTTYPE='ER' and EVNT.ERADMIT=1/Yes and
EVNT.EVUTSFLG ^=1/Yes.
DESIGN NOTES
9:55:40 AM Friday, March 06, 2009
Page 9 of 79
BOX IP1AA
BOX IP1AA
9:55:40 AM Friday, March 06, 2009
Page Order # :
16
Page 10 of 79
BOX IP1AA
BOX INSTRUCTIONS
( IPQ1017 )
CREATE EVENT FOR FIRST/NEXT ER VISIT ADDED WHERE SP WAS
ADMITTED TO HOSPITAL .
GO TO IP1A - EVENDMM ( IPQ1018 ).
ASSIGNMENTS
Current round Emergency Room visits that result in the SP being admitted to a hospital
should have a new current round IP event generated for the ER provider.
IP Event details will be collected on EVNT:
EVNT key = EVNT.EVNTBASE + EVNT.EVNTNUM.
EVNT.EVNTNUM = Number of event generated at BOX IP1AA.
BASE.LASTEVNT holds the highest EVNT.EVNTNUM prior to fielding cases. Not all
EVNT records are fielded. The first time an EVNT record is generated in the field,
BASE.LASTEVNT should be >= to the highest EVNT.EVNTNUM fielded. The new
EVNT.EVNTNUM should be calculated based on BASE.LASTEVNT + 001. Each time an
EVNT record is generated in the field, BASE.LASTEVNT will be updated to match the
highest EVNT.EVNTNUM in the field. Therefore, each time an EVNT record is generated in
the field, the new EVNT.EVNTNUM should be calculated based on BASE.LASTEVNT +
001. See detailed instructions below.
Data collected for Emergency Room visit added in ER section should be copied to new
Inpatient stay event. See detailed instructions below.
LASTEVNT
Once new EVNT record is generated, set
BASE.LASTEVNT = new EVNT.EVNTNUM.
EVNTNUM
Set new EVNT.EVNTNUM = BASE.LASTEVNT +
001. This assumes that BASE.LASTEVNT is
incremented each time an EVNT record is generated
in the field.
EVNTRNDC
EVNT.EVNTRNDC = current round.
EVNTTYPE
EVNT.EVNTTYPE = 'IP'.
STEVTYPE
EVNT.STEVTYPE=5/IP.
EVNTPROV
EVNT.EVNTPROV = EVNT.EVNTPROV from
Emergency Room event added at ER4 that is being
asked about.
HMOREFER
EVNT.HMOREFER=EVNT.HMOREFER from
Emergency Room event added at ER4 that is being
asked about.
NOGOHMO
EVNT.NOGOHMO=EVNT.NOGOHMO from
Emergency Room event added at ER4 that is being
asked about.
NOGOHMOS
EVNT.NOGOHMOS=EVNT.NOGOHMOS from
Emergency Room event added at ER4 that is being
asked about.
EVBEGMM
EVNT.EVBEGMM=EVNT.EVBEGMM from
Emergency Room event added at ER4 that is being
asked about.
9:55:40 AM Friday, March 06, 2009
Page 11 of 79
BOX IP1AA
EVBEGDD
EVNT.EVBEGDD=EVNT.EVBEGDD from
Emergency Room event added at ER4 that is being
asked about.
EVBEGYY
EVNT.EVBEGYY=EVNT.EVBEGYY from
Emergency Room event added at ER4 that is being
asked about.
TECHNICAL NOTES
DESIGN NOTES
9:55:40 AM Friday, March 06, 2009
Page 12 of 79
IP1A
IP1A
Page Order # :
Design Screen Type:
Date
Fields:
Field 1:
EVENDMM
Field 2:
EVENDDD
Field 3:
EVENDYY
Field 4:
STILLHOSP
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
Enable Functions:
17
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display the name of the hospital, PROV.PROVNAME, for the
Inpatient stay currently being asked about.
Display admission date for the Inpatient stay currently being asked
about.
Multi Field display:
Vertical Alignment
Display Discharge date input fields, EVENDMM, EVENDDD,
EVENDYY, on 1st line.
Display radio button for "SP STILL IN HOSPITAL", IP1A
STILLHOSP, on 2nd line.
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
9:55:42 AM Friday, March 06, 2009
Page 13 of 79
IP1A
Int. Instr I:
You told me [you were/(SP) was] admitted to (HOSPITAL NAME)
from the emergency room on (ADMISSION DATE). When [were
you/was (SP)] discharged from (HOSPITAL NAME) for the stay that
started on (ADMISSION DATE)?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
EVENDMM
Field1:
Cheshire Name:
( IPQ1018 )
EVNT.EVENDMM
Item Text display:
Item Text:
Label:
Label Position:
MM
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TMonthIntEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IP1A - EVENDDD ( IPQ1019 )
Don't know
IP1A - EVENDDD ( IPQ1019 )
Refusal
IP1A - EVENDDD ( IPQ1019 )
9:55:46 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
01
12
Route
IP1A - EVENDDD ( IPQ1019 )
Page 14 of 79
IP1A
EVENDDD
Field2:
Cheshire Name:
( IPQ1019 )
EVNT.EVENDDD
Item Text display:
Item Text:
Label:
Label Position:
DD
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TDayDKRFEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IP1A - EVENDYY ( IPQ1020 )
Don't know
IP1A - EVENDYY ( IPQ1020 )
Refusal
IP1A - EVENDYY ( IPQ1020 )
9:55:49 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
1
31
Route
IP1A - EVENDYY ( IPQ1020 )
Page 15 of 79
IP1A
EVENDYY
Field3:
Cheshire Name:
( IPQ1020 )
EVNT.EVENDYY
Item Text display:
Item Text:
Label:
Label Position:
YY
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TYear2DKRFEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IP1A - STILLHOSP ( IPQ1021 )
Don't know
IP1A - STILLHOSP ( IPQ1021 )
Refusal
IP1A - STILLHOSP ( IPQ1021 )
9:55:53 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
00
99
Route
IP1A - STILLHOSP ( IPQ1021 )
Page 16 of 79
IP1A
STILLHOSP
Field4:
Cheshire Name:
( IPQ1021 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TStillHosp
1
No
No
Number Label
1 StillInHosptial
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX IP1B - (IPQ1023 )
English text: SP IS STILL IN HOSPITAL
Attribute
Empty
Route
BOX IP1B - (IPQ1023 )
BACKGROUND VARIABLE ASSIGNMENTS
if IP1A - STILLHOSP = 1/SPStillInHospital, set IPSTATUS=1/StillInHospital.
Else if discharge date collected, set IPSTATUS=2/Discharged. See detailed instructions
below.
IPSTATUS
If STILLHOSP=1/StillInHosptial, set
EVNT.IPSTATUS=1/StillInHospital.
Else if discharge date is entered at IP1A, set
EVNT.IPSTATUS=2/Discharged.
SOFT EDIT CHECKS
Edit #1
If dates entered at IP1A do not have missing data,
EVBEGMM/EVBEGDD/EVBEGYY and
EVENDMM/EVENDDD/EVENDYY ^= DK and
EVBEGMM/EVBEGDD/EVBEGYY and
EVENDMM/EVENDDD/EVENDYY ^= RF, then Admission date,
EVBEGMM/EVBEGDD/EVBEGYY, and Discharge date,
EVENDMM/EVENDDD/EVENDYY, should not match.
If not true, display message "VERIFY THAT SP WAS ADMITTED
AND DISCHARGED ON THE SAME DATE."
HARD EDIT CHECKS
Edit #1:
If SP is deceased or institutionalized, then STILLHOSP should be
empty.
If not true, display message "PLEASE ENTER DISCHARGE DATE."
9:55:56 AM Friday, March 06, 2009
Page 17 of 79
IP1A
Edit #2:
Discharge date, EVENDMM,/EVENDDD/EVENDYY, and
STILLHOSP cannot both be EMPTY.
If not true, display message "PLEASE ENTER DISCHARGE DATE
OR SELECT "SP IS STILL IN HOSPITAL"."
Edit #3:
Discharge date, EVENDMM/EVENDDD/EVENDYY, and
STILLHOSP cannot both be filled.
If not true, display message "PLEASE ENTER DISCHARGE DATE
OR SELECT "SP IS STILL IN HOSPITAL"."
Edit #4:
Discharge Date, EVENDMM/EVENDDD/EVENDYY must be on or
before (TODAY/DATE OF DEATH/DATE OF
INSTITUTIONALIZATION).
If not true, display message: "INVALID DATE. DISCHARGE DATE
MUST BE ON OR BEFORE (TODAY/DATE OF DEATH/DATE OF
INSTITUTIONALIZATION)".
Edit #5:
Discharge Date, EVENDMM/EVENDDD/EVENDYY, must on or after
the (ADMISSION DATE).
If not true, display message: "INVALID DATE. DATE MUST BE ON
OR AFTER (ADMISSION DATE)".
Edit #6:
Inpatient Admission and Discharge Date cannot overlap an existing
IP stay.
If not true, display message "INVALID DATE. THIS DATE
OVERLAPS THE IP STAY FROM (ADMISSION DATE) TO
(DISCHARGE DATE)."
Display instructions: Display (ADMISSION DATE) and
(DISCHARGE DATE) of existing IP stay that the current IP stay
overlaps.
TECHNICAL NOTES
DESIGN NOTES
If the SP reported an Emergency Room visit in the ER section that resulted
in the SP being admitted to a hospital, we create an Inpatient stay at BOX
IP1AA and probe for the discharge date at IP1A.
9:55:56 AM Friday, March 06, 2009
Page 18 of 79
BOX IP1B
BOX IP1B
Page Order # :
18
BOX INSTRUCTIONS
( IPQ1023 )
IF SP WAS REPORTED AS STILL IN THE HOSPITAL AT IP1A, GO TO BOX
IP5 - (IPQ1370 ).
ELSE GO TO IP7 - ANYOPERS ( IPQ1240 ).
ASSIGNMENTS
TECHNICAL NOTES
140
SPStillInHosp
SP was reported as still in the hospital (in current round) =
For this EVNT, EVNT.IPSTATUS=1/StillInHospital.
DESIGN NOTES
9:55:56 AM Friday, March 06, 2009
Page 19 of 79
IP1
IP1
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
IPPROBE
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
20
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
If SP is deceased or institutionalized, display "was (SP)".
Else if proxy interview, display "has (SP) been".
Else display "have you been".
If IPS1 or IP1A asked in the current round, display "admitted any
other time to this or any other hospital".
Else display "admitted to a hospital".
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
9:55:57 AM Friday, March 06, 2009
[Since (REFERENCE DATE)/Between (REFERENCE DATE) and
(DATE OF DEATH/DATE OF INSTITUTIONALIZATION)], [have you
been/has (SP) been/was (SP)] [admitted to a hospital/admitted any
other time to this or any other hospital] as an inpatient -- either for an
overnight stay or for a "same day" procedure?
Page 20 of 79
IP1
IF HAD SAME DAY PROCEDURE AND IS NOT SURE IF
ADMITTED OR NOT, TREAT AS OUTPATIENT EVENT AND
ENTER WHEN YOU GET TO OP UTILIZATION.
Int. Instr II:
INPUT FIELDS / ROUTING
IPPROBE
Field1:
Cheshire Name:
Item Text display:
( IPQ1025 )
HRND.IPPROBE
Do not display option 3/IndicatedYesByDataprep.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TProbe
1
No
No
Number Label
1 Yes
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP2 - PROVIDER_IP ( IPQ1030 )
2
English text: YES
No
3
English text: NO
IndicatedYesByDataPrep
BOX IP6 - (IPQ1400 )
DO NOT DISPLAY.
DATA EDITING ONLY.
English text: INDICATED YES BY DATAPREP
Attribute
Don't know
Route
BOX IP6 - (IPQ1400 )
Refusal
BOX IP6 - (IPQ1400 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
9:56:01 AM Friday, March 06, 2009
Page 21 of 79
IP1
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
361
IPS1orIP1AAsked
IPS1 or IP1A asked in the current round =
(SP was still in a hospital at the time of the previous
round interview) or (SP had an emergency room visit in
the current round that resulted in the SP being admitted
to hospital).
137
SPStillInHospPrevRnd
SP was still in a hospital at the time of the previous round
interview =
There is an EVNT where EVNT.EVNTDFLG^=1/Yes and
EVNT.EVNTTYPE='IP' and
EVNT.IPSTATUS=1/StillInHospital.
138
ERtoIPStay
SP had an emergency room visit in the current round that
resulted in the SP being admitted to hospital =
There is an EVNT where EVNT.EVNTDFLG^=1/Yes and
EVNT.EVNTRNDC=current round and
EVNT.EVNTTYPE='ER' and EVNT.ERADMIT=1/Yes and
EVNT.EVUTSFLG ^=1/Yes.
DESIGN NOTES
9:56:01 AM Friday, March 06, 2009
Page 22 of 79
IP2
IP2
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
PROVIDER_IP
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Name:
Provider Roster
Roster Type:
Single Item Select
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
Yes
Yes
No
No
Grid Functions:
Add Line
Delete Line
No
No
30
Display as ' Add a Hospital '
Display as ' Edit a Hospital '
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Multi Field display:
Roster/Grid Instructions:
Display all Providers except for Providers where
PROV.PROVNUM=01 and 02, which are reserved for PM and OM
events.
Display in order of entry.
Roster/Grid display:
COL #
HEADER
1
Provider Name
INSTRUCTIONS
Display PROV.PROVNAME.
Report display:
TEXT:
Context Header:
REFERENCE PERIOD: (REFERENCE DATE) - (TODAY/DATE OF
DEATH/DATE OF INSTITUTIONALIZATION)
Int. Instr I:
Question Text:
Where [were you/was (SP)] admitted -- to which hospital?
Int. Instr II:
SELECT OR ADD ONLY ONE HOSPITAL.
9:56:01 AM Friday, March 06, 2009
Page 23 of 79
IP2
INPUT FIELDS / ROUTING
Field1:
Cheshire Name:
PROVIDER_IP
( IPQ1030 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
String
TProvPick4
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
4
Route
BOX IP2 - (IPQ1050 )
BACKGROUND VARIABLE ASSIGNMENTS
PROVIDER INSTRUCTIONS:
Roster details will be collected on PROV:
PROV key = PROV.PROVBASE + PROV.PROVNUM
PROV.PROVNUM = Number of Provider selected at IP2.
If Provider added at Provider Roster, see PROVIDER ROSTER POP-UP specifications for
pop-up window programming instructions.
Variables populated in Provider Roster Pop-Up Window:
PROV.PROVNUM
PROV.PROVRNDC
PROV.PROVNAME
Provider Number
Round number
Hospital name (Also known as Provider name)
If Provider added, set provider type as instructed below.
EVENT INSTRUCTIONS:
Current round IP visits are stored on EVNT. An EVNT is generated once the Provider is
selected at IP2:
EVNT key = EVNT.EVNTBASE + EVNT.EVNTNUM
EVNT.EVNTNUM = Number of event generated at IP2.
BASE.LASTEVNT holds the highest EVNT.EVNTNUM prior to fielding cases. Not all
EVNT records are fielded. The first time an EVNT record is generated in the field,
BASE.LASTEVNT should be >= to the highest EVNT.EVNTNUM fielded. The new
EVNT.EVNTNUM should be calculated based on BASE.LASTEVNT + 001. Each time an
EVNT record is generated in the field, BASE.LASTEVNT will be updated to match the
highest EVNT.EVNTNUM in the field. Therefore, each time an EVNT record is generated in
9:56:02 AM Friday, March 06, 2009
Page 24 of 79
IP2
the field, the new EVNT.EVNTNUM should be calculated based on BASE.LASTEVNT +
001. See detailed instructions below.
Set Event Provider as the Provider selected at IP2. Set additional EVNT variables as
instructed below:
EVNTNUM
Set new EVNT.EVNTNUM = BASE.LASTEVNT +
001. This assumes that BASE.LASTEVNT is
incremented each time an EVNT record is generated
in the field.
EVNTRNDC
EVNT.EVNTRNDC = current round.
EVNTTYPE
EVNT.EVNTTYPE = 'IP'.
STEVTYPE
EVNT.STEVTYPE = 5/IP.
EVNTPROV
EVNT.EVNTPROV = PROV.PROVNUM of provider
selected at IP2.
PROVTYPE
If Provider added at IP2, set
PROV.PROVTYPE=3/InPatientHospital.
LASTEVNT
Once new EVNT record is generated, set
BASE.LASTEVNT = new EVNT.EVNTNUM.
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
9:56:02 AM Friday, March 06, 2009
Page 25 of 79
BOX IP2
BOX IP2
Page Order # :
40
BOX INSTRUCTIONS
( IPQ1050 )
IF (SP REPORTED RECEIVING HEALTH CARE SERVICES THROUGH V.A.
IN THE CURRENT ROUND OR ANY PREVIOUS ROUND) AND (IF THIS
PROVIDER IS ASSOCIATED WITH V.A. IS UNKNOWN), GO TO IP3 VAPLACE ( IPQ1060 ).
ELSE GO TO BOX IP2AA - (IPQ1070 ).
ASSIGNMENTS
TECHNICAL NOTES
423
SPReceivedCaretThruV
A
SP reported receiving health care services through V.A.in
the current or any previous round =
There is an HRND where HRND.HRNDRND = current
round and HRND.VACOVER = 1/Yes.
HRND.VACOVER is set at BOX HI20 or collected at HI36.
127
ProviderVAUnknown
If Provider is associated with V.A. is unknown =
PROV.VAPLACE = empty.
DESIGN NOTES
9:56:02 AM Friday, March 06, 2009
Page 26 of 79
IP3
IP3
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
VAPLACE
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
50
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display name of hospital, PROV.PROVNAME, currently being
asked about.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
Is (HOSPITAL NAME) a Department of Veterans Affairs, or V.A.,
facility?
Int. Instr II:
INPUT FIELDS / ROUTING
9:56:04 AM Friday, March 06, 2009
Page 27 of 79
IP3
VAPLACE
Field1:
Cheshire Name:
( IPQ1060 )
PROV.VAPLACE
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX IP2AA - (IPQ1070 )
English text: YES
No
BOX IP2AA - (IPQ1070 )
English text: NO
Attribute
Don't know
Route
BOX IP2AA - (IPQ1070 )
Refusal
BOX IP2AA - (IPQ1070 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
9:56:06 AM Friday, March 06, 2009
Page 28 of 79
BOX IP2AA
BOX IP2AA
9:56:06 AM Friday, March 06, 2009
Page Order # :
60
Page 29 of 79
BOX IP2AA
BOX INSTRUCTIONS
( IPQ1070 )
IF (SP COVERED BY A MANAGED CARE PLAN ANYTIME DURING THE
CURRENT ROUND) AND (IF THIS PROVIDER IS ASSOCIATED WITH A
MANAGED CARE PLAN IS UNKNOWN), GO TO IP3A - HMOASSOC (
IPQ1080 ).
ELSE IF (SP COVERED BY A MANAGED CARE PLAN ANYTIME DURING
THE CURRENT ROUND) AND (THIS PROVIDER IS NOT ASSOCIATED
WITH A MANAGED CARE PLAN), GO TO IP3B - HMOREFER ( IPQ1090 ).
ELSE GO TO IP4 - EVBEGMM ( IPQ1130 ).
ASSIGNMENTS
TECHNICAL NOTES
52
DeletedPlans
Deleted plans that are not valid for displays or checks =
Any PLAN where (PLAN.PLANDFLG=1/Yes or
PLAN.MHMODFLG=1/Yes or PLAN.PLANHIDE=1/Yes or
PLAN.LOSEPLFG ^=EMPTY) is a deleted PLAN.
2
ManagedCarePlan
SP covered by a Managed Care Plan anytime during
current round =
There is a PLRO.PLROPLAN=PLAN.PLANUM &
PLRO.PLRORND=current round &
((PLRO.PPRVHMO=1/Yes) or (PLAN.PLANTYPE =
5/MHMO & PLRO.COVANYTM=1/Yes) or
(PLRO.MCAIDHMO=1/Yes)). See T.N. 52.
128
ProviderHMOUnknown
If Provider is associated with a Managed Care plan is
unknown =
PROV.HMOASSOC=empty.
130
ProviderNotHMO
Provider is not associated with a Managed Care plan =
PROV.HMOASSOC=2/No, DK, or RF.
129
ProviderAssocHMO
Provider is associated with a Managed Care plan =
PROV.HMOASSOC=1/Yes.
DESIGN NOTES
If the SP belongs to a managed care plan (HMO), we ask each provider
selected/added if the provider is associated with an HMO. This question,
which is asked throughout utilization and cost series, is only asked once
in the study for each provider. The response is never updated. (this
design may change in the future).
If the SP belongs to an HMO, and we have not asked this question for this
provider, HMOASSOC=empty, BOX IP2AA is routed to IP3A
HMOASSOC. If we have already asked this question about this provider,
and the provider responded to HMOASSOC=No, DK or RF, BOX IP2AA
is routed to IP3B, skipping IP3A, to determine if the SP was referred to
this provider by their HMO.
If SP does not belong to an HMO or this provider already reported being
associated with the HMO, BOX IP2AA routes directly to IP4, collects
admission and discharge dates, skipping IP3A and IP3B.
9:56:06 AM Friday, March 06, 2009
Page 30 of 79
IP3A
IP3A
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HMOASSOC
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
70
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display name of hospital, PROV.PROVNAME, currently being
asked about.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all managed care plans SP was covered by anytime during
the current round.
Display managed care plan name(s) below question text.
Display plans in the following order: Medicare Managed Care plans,
Medicaid Managed Care plans, and Private Managed Care plans. If
there is more than one plan for any specific plan type, display in
order of entry.
Column 1, header = "MANAGED CARE PLANS".
Column 1, display= If Medicaid Managed Care Plan, display
"Medicaid Managed Care Plan".
Else display health insurance plan name "(PLAN NAME) Managed
Care Plan".
TEXT:
Context Header:
9:56:07 AM Friday, March 06, 2009
Page 31 of 79
IP3A
Int. Instr I:
Is (HOSPITAL NAME) associated with [your/(SP’s)] [READ
MANAGED CARE PLAN NAME(S) BELOW] plan?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HMOASSOC
Field1:
Cheshire Name:
( IPQ1080 )
PROV.HMOASSOC
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP4 - EVBEGMM ( IPQ1130 )
English text: YES
No
IP3B - HMOREFER ( IPQ1090 )
English text: NO
Attribute
Don't know
Route
IP3B - HMOREFER ( IPQ1090 )
Refusal
IP3B - HMOREFER ( IPQ1090 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
52
DeletedPlans
9:56:10 AM Friday, March 06, 2009
Deleted plans that are not valid for displays or checks =
Page 32 of 79
IP3A
Any PLAN where (PLAN.PLANDFLG=1/Yes or
PLAN.MHMODFLG=1/Yes or PLAN.PLANHIDE=1/Yes or
PLAN.LOSEPLFG ^=EMPTY) is a deleted PLAN.
2
ManagedCarePlan
SP covered by a Managed Care Plan anytime during
current round =
There is a PLRO.PLROPLAN=PLAN.PLANUM &
PLRO.PLRORND=current round &
((PLRO.PPRVHMO=1/Yes) or (PLAN.PLANTYPE =
5/MHMO & PLRO.COVANYTM=1/Yes) or
(PLRO.MCAIDHMO=1/Yes)). See T.N. 52.
107
PlanIsMCaidHMO
SP is covered by a Medicaid Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=2/Medicaid &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.MCAIDHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
111
PlanIsMCareHMO
SP is covered by a Medicare Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=5/MHMO &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.COVANYTM=1/Yes).
Exclude Deleted Plans. See T.N. 52.
112
PlanIsPrivateHMO
SP is covered by a Private Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=4/PrivatePlan
& PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.PPRVHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
106
HIPlanName
Health Insurance Plan Roster is stored on PLAN.
Plan name = PLAN.PLNAME.
DESIGN NOTES
9:56:10 AM Friday, March 06, 2009
Page 33 of 79
IP3B
IP3B
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
HMOREFER
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
80
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display name of hospital, PROV.PROVNAME, currently being
asked about.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display all managed care plans SP was covered by anytime during
the current round.
Display managed care plan name(s) below question text.
Display plans in the following order: Medicare Managed Care plans,
Medicaid Managed Care plans, and Private Managed Care plans. If
there is more than one plan for any specific plan type, display in
order of entry.
Column 1, header = "MANAGED CARE PLANS".
Column 1, display= If Medicaid Managed Care Plan, display
"Medicaid Managed Care Plan".
Else display health insurance plan name "(PLAN NAME) Managed
Care Plan".
TEXT:
Context Header:
9:56:11 AM Friday, March 06, 2009
Page 34 of 79
IP3B
Int. Instr I:
[Were you/Was (SP)] referred to (HOSPITAL NAME) by [READ
MANAGED CARE PLAN NAME(S) BELOW]?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
HMOREFER
Field1:
Cheshire Name:
( IPQ1090 )
EVNT.HMOREFER
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP4 - EVBEGMM ( IPQ1130 )
English text: YES
No
IP3D - NOGOHMO ( IPQ1100 )
English text: NO
Attribute
Don't know
Route
IP4 - EVBEGMM ( IPQ1130 )
Refusal
IP4 - EVBEGMM ( IPQ1130 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
52
DeletedPlans
9:56:14 AM Friday, March 06, 2009
Deleted plans that are not valid for displays or checks =
Page 35 of 79
IP3B
Any PLAN where (PLAN.PLANDFLG=1/Yes or
PLAN.MHMODFLG=1/Yes or PLAN.PLANHIDE=1/Yes or
PLAN.LOSEPLFG ^=EMPTY) is a deleted PLAN.
2
ManagedCarePlan
SP covered by a Managed Care Plan anytime during
current round =
There is a PLRO.PLROPLAN=PLAN.PLANUM &
PLRO.PLRORND=current round &
((PLRO.PPRVHMO=1/Yes) or (PLAN.PLANTYPE =
5/MHMO & PLRO.COVANYTM=1/Yes) or
(PLRO.MCAIDHMO=1/Yes)). See T.N. 52.
107
PlanIsMCaidHMO
SP is covered by a Medicaid Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=2/Medicaid &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.MCAIDHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
111
PlanIsMCareHMO
SP is covered by a Medicare Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=5/MHMO &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.COVANYTM=1/Yes).
Exclude Deleted Plans. See T.N. 52.
112
PlanIsPrivateHMO
SP is covered by a Private Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=4/PrivatePlan
& PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.PPRVHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
106
HIPlanName
Health Insurance Plan Roster is stored on PLAN.
Plan name = PLAN.PLNAME.
DESIGN NOTES
9:56:14 AM Friday, March 06, 2009
Page 36 of 79
IP3D
IP3D
Page Order # :
Design Screen Type:
Code 1
Fields:
Field 1:
NOGOHMO
Field 2:
NOGOHMOS
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
Enable Functions:
91
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Multi Field display:
Vertical Alignment
Roster/Grid Instructions:
Roster/Grid display:
Report display:
Display managed care plan name(s) below question text.
Display plans in the following order: Medicare Managed Care plans,
Medicaid Managed Care plans, and Private Managed Care plans. If
there is more than one plan for any specific plan type, display in
order of entry.
Column 1, header = "MANAGED CARE PLANS".
Column 1, display= If Medicaid Managed Care Plan, display
"Medicaid Managed Care Plan".
Else display health insurance plan name "(PLAN NAME) Managed
Care Plan".
TEXT:
Context Header:
Int. Instr I:
9:56:17 AM Friday, March 06, 2009
Page 37 of 79
IP3D
Question Text:
What is the most important reason [you/(SP)] did not go to a hospital
associated with [READ MANAGED CARE PLAN NAME(S) BELOW]
or a hospital that [READ MANAGED CARE PLAN NAME(S)
BELOW] would refer [you/(SP)] to?
Int. Instr II:
SCROLL DOWN TO SEE RESPONSE CATEGORIES.
INPUT FIELDS / ROUTING
9:56:22 AM Friday, March 06, 2009
Page 38 of 79
IP3D
NOGOHMO
Field1:
Cheshire Name:
Item Text display:
( IPQ1100 )
EVNT.NOGOHMO
Display responses in one column.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
Tnogohmo
1
No
No
Number Label
1 PlanNotCoverService
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP4 - EVBEGMM ( IPQ1130 )
English text: PLAN DOES NOT COVER THE SERVICE SP WANTED
DifficultyDelayGettingService
IP4 - EVBEGMM ( IPQ1130 )
4
English text: DIFFICULTY OR DELAY IN GETTING SERVICES
SPProviderPreference
IP4 - EVBEGMM ( IPQ1130 )
English text: SP PROVIDER PREFERENCE
ServiceCoverdbyOtherInsurance
IP4 - EVBEGMM ( IPQ1130 )
5
English text: THIS SERVICE WAS COVERED BY OTHER INSURANCE SP HAS
NotinManagedCareTimeofEvent
IP4 - EVBEGMM ( IPQ1130 )
6
English text: NOT IN A MANAGED CARE PLAN AT TIME OF EVENT
NoChoiceMedEmergency
IP4 - EVBEGMM ( IPQ1130 )
3
91
English text: NO CHOICE - MEDICAL EMERGENCY OR OUT OF SERVICE AREA
Other
IP3D - NOGOHMOS ( IPQ1110 )
English text: OTHER
Attribute
Don't know
Route
IP4 - EVBEGMM ( IPQ1130 )
Refusal
IP4 - EVBEGMM ( IPQ1130 )
9:56:28 AM Friday, March 06, 2009
Page 39 of 79
IP3D
NOGOHMOS
Field2:
Cheshire Name:
( IPQ1110 )
EVNT.NOGOHMOS
Item Text display:
Display "(SPECIFY)" in same blue font used for interviewer
instructions.
Item Text:
OTHER (SPECIFY)
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
String
TOthrspec
FieldSize:
Min Value:
Max Value:
Mask:
1
No
No
Number Label
1 [Continuous answer.]
30
Route
IP4 - EVBEGMM ( IPQ1130 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
52
DeletedPlans
Deleted plans that are not valid for displays or checks =
Any PLAN where (PLAN.PLANDFLG=1/Yes or
PLAN.MHMODFLG=1/Yes or PLAN.PLANHIDE=1/Yes or
PLAN.LOSEPLFG ^=EMPTY) is a deleted PLAN.
2
ManagedCarePlan
SP covered by a Managed Care Plan anytime during
current round =
There is a PLRO.PLROPLAN=PLAN.PLANUM &
PLRO.PLRORND=current round &
((PLRO.PPRVHMO=1/Yes) or (PLAN.PLANTYPE =
5/MHMO & PLRO.COVANYTM=1/Yes) or
(PLRO.MCAIDHMO=1/Yes)). See T.N. 52.
107
PlanIsMCaidHMO
SP is covered by a Medicaid Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=2/Medicaid &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.MCAIDHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
9:56:29 AM Friday, March 06, 2009
Page 40 of 79
IP3D
111
PlanIsMCareHMO
SP is covered by a Medicare Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=5/MHMO &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.COVANYTM=1/Yes).
Exclude Deleted Plans. See T.N. 52.
112
PlanIsPrivateHMO
SP is covered by a Private Managed Care Plan during
the current round =
There is a PLAN where PLAN.PLANTYPE=4/PrivatePlan
& PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.PPRVHMO=1/Yes).
Exclude Deleted Plans. See T.N. 52.
106
HIPlanName
Health Insurance Plan Roster is stored on PLAN.
Plan name = PLAN.PLNAME.
DESIGN NOTES
9:56:29 AM Friday, March 06, 2009
Page 41 of 79
IP4
IP4
Page Order # :
Design Screen Type:
Date
Fields:
Field 1:
EVBEGMM
Field 2:
EVBEGDD
Field 3:
EVBEGYY
Field 4:
EVENDMM
Field 5:
EVENDDD
Field 6:
EVENDYY
Field 7:
STILLHOSP
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
Enable Functions:
110
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display name of hospital, PROV.PROVNAME, currently being
asked about.
Multi Field display:
Vertical Alignment
Display Admission date input fields, EVBEGMM, EVBEGDD,
EVBEGYY, on 1st line.
Display discharge date input fields, EVENDMM, EVENDDD,
EVENDYY, on 2nd line.
Display radio button for "SP STILL IN HOSPITAL" , IP4
STILLHOSP, on 3rd line.
Roster/Grid Instructions:
Roster/Grid display:
Report display:
9:56:31 AM Friday, March 06, 2009
Page 42 of 79
IP4
TEXT:
REFERENCE PERIOD: (REFERENCE DATE) - (TODAY/DATE OF
DEATH/DATE OF INSTITUIONALIZATION)
Context Header:
Int. Instr I:
When [were you/was (SP)] admitted to and discharged from
(HOSPITAL NAME)?
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
EVBEGMM
Field1:
Cheshire Name:
( IPQ1130 )
EVNT.EVBEGMM
Item Text display:
Item Text:
ADMISSION DATE:
Label:
Label Position:
MM
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TMonthInt
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IP4 - EVBEGDD ( IPQ1131 )
Refusal
IP4 - EVBEGDD ( IPQ1131 )
9:56:35 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
01
12
Route
IP4 - EVBEGDD ( IPQ1131 )
Page 43 of 79
IP4
EVBEGDD
Field2:
Cheshire Name:
( IPQ1131 )
EVNT.EVBEGDD
Item Text display:
Item Text:
Label:
Label Position:
DD
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TDayDKRF
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IP4 - EVBEGYY ( IPQ1132 )
Refusal
IP4 - EVBEGYY ( IPQ1132 )
9:56:39 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
1
31
Route
IP4 - EVBEGYY ( IPQ1132 )
Page 44 of 79
IP4
EVBEGYY
Field3:
Cheshire Name:
( IPQ1132 )
EVNT.EVBEGYY
Item Text display:
Item Text:
Label:
Label Position:
YY
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TYear2DKRF
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Don't know
Route
IP4 - EVENDMM ( IPQ1140 )
Refusal
IP4 - EVENDMM ( IPQ1140 )
9:56:42 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
00
99
Route
IP4 - EVENDMM ( IPQ1140 )
Page 45 of 79
IP4
EVENDMM
Field4:
Cheshire Name:
( IPQ1140 )
EVNT.EVENDMM
Item Text display:
Item Text:
DISCHARGE DATE:
Label:
Label Position:
MM
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TMonthIntEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IP4 - EVENDDD ( IPQ1160 )
Don't know
IP4 - EVENDDD ( IPQ1160 )
Refusal
IP4 - EVENDDD ( IPQ1160 )
9:56:46 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
01
12
Route
IP4 - EVENDDD ( IPQ1160 )
Page 46 of 79
IP4
EVENDDD
Field5:
Cheshire Name:
( IPQ1160 )
EVNT.EVENDDD
Item Text display:
Item Text:
Label:
Label Position:
DD
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TDayDKRFEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IP4 - EVENDYY ( IPQ1180 )
Don't know
IP4 - EVENDYY ( IPQ1180 )
Refusal
IP4 - EVENDYY ( IPQ1180 )
9:56:49 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
1
31
Route
IP4 - EVENDYY ( IPQ1180 )
Page 47 of 79
IP4
EVENDYY
Field6:
Cheshire Name:
( IPQ1180 )
EVNT.EVENDYY
Item Text display:
Item Text:
Label:
Label Position:
YY
Under
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Integer
TYear2DKRFEmpty
1
No
No
Number Label
1 [Continuous answer.]
Attribute
Empty
Route
IP4 - STILLHOSP ( IPQ1182 )
Don't know
IP4 - STILLHOSP ( IPQ1182 )
Refusal
IP4 - STILLHOSP ( IPQ1182 )
9:56:53 AM Friday, March 06, 2009
FieldSize:
Min Value:
Max Value:
Mask:
2
00
99
Route
IP4 - STILLHOSP ( IPQ1182 )
Page 48 of 79
IP4
STILLHOSP
Field7:
Cheshire Name:
( IPQ1182 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TStillHosp
1
No
No
Number Label
1 StillInHosptial
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX IP3 - (IPQ1230 )
English text: SP IS STILL IN HOSPITAL
Attribute
Empty
Route
BOX IP3 - (IPQ1230 )
BACKGROUND VARIABLE ASSIGNMENTS
Set status of IP visit as instructed below:
IPSTATUS
If STILLHOSP=1/StillInHosptial, set
EVNT.IPSTATUS=1/StillInHospital.
Else if discharge date is entered at IP1A, set
EVNT.IPSTATUS=2/Discharged.
SOFT EDIT CHECKS
Edit #1
If dates entered at IP4 do not have missing data,
EVBEGMM/EVBEGDD/EVBEGYY and
EVENDMM/EVENDDD/EVENDYY ^= DK and
EVBEGMM/EVBEGDD/EVBEGYY and
EVENDMM/EVENDDD/EVENDYY ^= RF, then Admission date,
EVBEGMM/EVBEGDD/EVBEGYY, and Discharge date,
EVENDMM/EVENDDD/EVENDYY, should not match.
If not true, display message "VERIFY THAT SP WAS ADMITTED
AND DISCHARGED ON THE SAME DATE."
HARD EDIT CHECKS
Edit #1:
If SP is deceased or institutionalized, then STILLHOSP should be
empty.
If not true, display message "PLEASE ENTER DISCHARGE DATE."
Edit #2:
9:56:56 AM Friday, March 06, 2009
Page 49 of 79
IP4
Discharge date, EVENDMM,/EVENDDD/EVENDYY, and
STILLHOSP cannot both be EMPTY.
If not true, display message "PLEASE ENTER DISCHARGE DATE
OR SELECT "SP IS STILL IN HOSPITAL"."
Edit #3:
Discharge date, EVENDMM/EVENDDD/EVENDYY, and
STILLHOSP cannot both be filled.
If not true, display message "PLEASE ENTER DISCHARGE DATE
OR SELECT "SP IS STILL IN HOSPITAL"."
Edit #4:
Admission date, EVBEGMM/EVBEGDD/EVBEGYY, must be on or
between (REFERENCE DATE) and (TODAY/DATE OF
DEATH/DATE OF INSTITUTIONALIZATION).
If not true, display message "INVALID DATE. ADMISSION DATE
MUST BE ON OR BETWEEN (REFERENCE DATE) AND
(TODAY/DATE OF DEATH/DATE OF INSTITUTIONALIZATION)".
INVOLVES EVBEGMM, EVBEGDD, EVBEGYY.
Edit #5:
Discharge date, EVENDMM/EVENDDD/EVENDYY, must be on or
between (ADMISSION DATE) and (TODAY/DATE OF DEATH/DATE
OF INSTITUTIONALIZATION).
If not true, display message "INVALID DATE. DISCHARGE DATE
MUST BE ON OR BETWEEN (ADMISSION DATE) AND
(TODAY/DATE OF DEATH/DATE OF INSTITUTIONALIZATION)".
INVOLVES EVENDMM, EVENDDD, EVENDYY.
Edit #6:
Admission date, EVBEGMM/EVBEGDD/EVBEGYY, cannot match
an existing IP stay admission date for the same provider. If the
Admission date does not have missing data, EVBEGMM,
EVBEGDD, EVBEGYY ^= DK and EVBEGMM, EVBEGDD,
EVBEGYY ^= RF, then check this date against other IP stay
admission dates for this provider.
The following must be true for the IP stay added at IP4 to be a
duplicate of an existing IP stay:
Both EVNTDFLG ^= 1/Yes,
Both EVNTTYPE=IP,
(Both EVNTRNDC=current round) or (Existing IP stay
EV95FLG=previous round),
EVNTPROV matches,
EVBEGMM matches,
EVBEGDD matches,
EVBEGYY matches.
The Admission date added at IP4 cannot match an existing IP stay
admission date for the same provider.
If not true, display message "INVALID RESPONSE. THE
ADMISSION DATE MATCHES AN EXISTING ADMISSION DATE
TO (HOSPITAL NAME)."
Display instructions: Display hospital name, PROV.PROVNAME,
selected at IP2.
Edit #7:
Discharge date, EVENDMM/EVENDDD/EVENDYY, cannot match
an existing IP stay discharge date for the same provider. If the
Discharge date does not have missing data, EVENDMM, EVENDDD,
EVENDYY ^= DK and EVENDMM, EVENDDD, EVENDYY ^= RF,
9:56:56 AM Friday, March 06, 2009
Page 50 of 79
IP4
then check this date against other IP stay discharge dates for this
provider.
The following must be true for the IP stay added at IP4 to be a
duplicate of an existing IP stay:
Both EVNTDFLG ^= 1/Yes,
(Both EVNTRNDC=current round) or (Existing IP stay
EV95FLG=previous round),
Both EVNTTYPE=IP,
EVNTPROV matches,
EVENDMM matches,
EVENDDD matches,
EVENDYY matches.
The Discharge date added at IP4 cannot match an existing IP stay
discharge date for the same provider.
If not true, display message "INVALID RESPONSE. THE
DISCHARGE DATE MATCHES AN EXISTING DISCHARGE DATE
TO (HOSPITAL NAME)."
Display instructions: Display hospital name, PROV.PROVNAME,
selected at IP2.
Edit #8:
Inpatient Admission and Discharge Date cannot overlap an existing
IP stay.
If not true, display message "INVALID DATE. THIS DATE
OVERLAPS AN EXISTING IP STAY FROM (ADMISSION DATE) TO
[(DISCHARGE DATE)/SP STILL IN HOSPITAL]."
Display instructions:
Display (ADMISSION DATE) of existing IP stay that the IP stay
added at IP4 overlaps.
If existing IP stay IPSTATUS=1/StillInHosptial, display "SP STILL IN
HOSPITAL".
Else display (DISCHARGE DATE) of existing IP stay that the IP stay
added at IP4 overlaps.
See General specifcations for overlapping date logic.
TECHNICAL NOTES
DESIGN NOTES
9:56:56 AM Friday, March 06, 2009
Page 51 of 79
BOX IP3
BOX IP3
Page Order # :
140
BOX INSTRUCTIONS
( IPQ1230 )
IF SP WAS REPORTED AS STILL IN THE HOSPITAL AT IP4, GO TO BOX
IP5 - (IPQ1370 ).
ELSE GO TO IP7 - ANYOPERS ( IPQ1240 ).
ASSIGNMENTS
TECHNICAL NOTES
140
SPStillInHosp
SP was reported as still in the hospital (in current round) =
For this EVNT, EVNT.IPSTATUS=1/StillInHospital.
DESIGN NOTES
9:56:56 AM Friday, March 06, 2009
Page 52 of 79
IP7
IP7
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
ANYOPERS
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
150
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display admission date,
EVNT.EVBEGMM/EVNT.EVBEGDD/EVNT.EVBEGYY.
Display discharge date,
EVNT.EVENDMM/EVNT.EVENDDD/EVNT.EVENDYY.
If IP7 is being asked for the first time in the current round interview,
display, "[Operations include surgery..]". Always display this
sentence in brackets.
Else do not display.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
9:56:57 AM Friday, March 06, 2009
Were any operations performed on [you/(SP)] during the hospital
stay that was (ADMISSION DATE) to (DISCHARGE DATE)?
Page 53 of 79
IP7
[Operations include surgery and other surgical procedures like
setting bones, stitching or removing growths, or any cutting of the
skin.]
Int. Instr II:
INPUT FIELDS / ROUTING
ANYOPERS
Field1:
Cheshire Name:
( IPQ1240 )
EVNT.ANYOPERS
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP11 - CONDITION_IP ( IPQ1290 )
English text: YES
No
IP10 - SPECCOND ( IPQ1280 )
English text: NO
Attribute
Don't know
Route
IP10 - SPECCOND ( IPQ1280 )
Refusal
IP10 - SPECCOND ( IPQ1280 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
9:57:00 AM Friday, March 06, 2009
Page 54 of 79
IP7
DESIGN NOTES
Called by BOX ST22A or BOX NS22A if IP event added in ST or NS.
9:57:00 AM Friday, March 06, 2009
Page 55 of 79
IP10
IP10
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
SPECCOND
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
190
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Display admission date,
EVNT.EVBEGMM/EVNT.EVBEGDD/EVNT.EVBEGYY.
Display discharge date,
EVNT.EVENDMM/EVNT.EVENDDD/EVNT.EVENDYY.
Question display:
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
DATES OF HOSPITAL STAY: (ADMISSION DATE) - (DISCHARGE
DATE)
Int. Instr I:
Question Text:
Was this hospital stay for any specific condition?
Int. Instr II:
INPUT FIELDS / ROUTING
9:57:01 AM Friday, March 06, 2009
Page 56 of 79
IP10
SPECCOND
Field1:
Cheshire Name:
( IPQ1280 )
EVNT.SPECCOND
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP11 - CONDITION_IP ( IPQ1290 )
English text: YES
No
IP12 - PDNCARE ( IPQ1300 )
English text: NO
Attribute
Don't know
Route
IP12 - PDNCARE ( IPQ1300 )
Refusal
IP12 - PDNCARE ( IPQ1300 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
9:57:03 AM Friday, March 06, 2009
Page 57 of 79
IP11
IP11
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
CONDITION_IP
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Name:
Condition Roster
Roster Type:
Multiple Item Select
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
Yes
Yes
No
No
Grid Functions:
Add Line
Delete Line
No
No
200
Display as ' Add a Condition '
Display as ' Edit a Condition '
DISPLAY INSTRUCTIONS:
Context header display:
Display admission date,
EVNT.EVBEGMM/EVNT.EVBEGDD/EVNT.EVBEGYY, for IP event
being asked about.
Display discharge date,
EVNT.EVENDMM/EVNT.EVENDDD/EVNT.EVENDYY, for IP event
being asked about.
Question display:
If IP7 = 1\Yes, then display "What condition required the surgery".
Else display "What was the condition".
Multi Field display:
Roster/Grid Instructions:
Display all Conditions.
Display in alphabetical order.
Roster/Grid display:
COL #
1
HEADER
Condition
INSTRUCTIONS
Display condition name,
COND.CONDITION
Report display:
TEXT:
Context Header:
9:57:04 AM Friday, March 06, 2009
DATES OF HOSPITAL STAY: (ADMISSION DATE) - (DISCHARGE
DATE)
Page 58 of 79
IP11
Int. Instr I:
Question Text:
(What condition required the surgery/What was the condition)?
Int. Instr II:
SELECT OR ADD ALL CONDITIONS.
INPUT FIELDS / ROUTING
Field1:
Cheshire Name:
CONDITION_IP
( IPQ1290 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
String
TCondPick135
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
135
Route
IP12 - PDNCARE ( IPQ1300 )
BACKGROUND VARIABLE ASSIGNMENTS
Conditions will be collected on COND:
COND key = COND.CONDBASE + COND.CONDNUM
COND.CONDNUM = Number of condition selected at IP11.
If adding a new condition, see CONDITION ROSTER POP-UP specifications for pop-up
window programming instructions.
Variables populated at the Condition Roster:
COND.CONDNUM
COND.CONDRNDC
COND.CONDTION
All Conditions selected at IP11 should be linked to the Inpatient Stay being asked about.
Link Conditions to IP visit on XCON.
XCON key = XCON.XCONBASE + XCON.XCONEVNT + XCON.XCONBAS2 +
XCON.XCONCOND.
For each condition selected at IP11, create an XCON where XCONEVNT=
EVNT.EVNTNUM of Inpatient Stay and XCONCOND = COND.CONDNUM of Condition.
XCONBASE and XCONBAS2 both equal the Cheshire BASE.BASEID. Set additional
XCON variables as specified below.
XCONEVNT
9:57:05 AM Friday, March 06, 2009
XCON.XCONEVNT = EVNT.EVNTNUM of Inpatient
Page 59 of 79
IP11
Stay being asked about.
XCONCOND
XCON.XCONCOND = COND.CONDNUM of
Condition selected at IP11.
XCONRNDC
XCON.XCONRNDC = current round.
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
9:57:05 AM Friday, March 06, 2009
Page 60 of 79
IP12
IP12
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
PDNCARE
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
210
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Display admission date,
EVNT.EVBEGMM/EVNT.EVBEGDD/EVNT.EVBEGYY.
Display discharge date,
EVNT.EVENDMM/EVNT.EVENDDD/EVNT.EVENDYY.
Question display:
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
DATES OF HOSPITAL STAY: (ADMISSION DATE) - (DISCHARGE
DATE)
Int. Instr I:
Question Text:
During this hospitalization, did [you/(SP)] have any special or private
duty nursing care?
Int. Instr II:
9:57:06 AM Friday, March 06, 2009
Page 61 of 79
IP12
INPUT FIELDS / ROUTING
PDNCARE
Field1:
Cheshire Name:
( IPQ1300 )
EVNT.PDNCARE
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX IP4A - (IPQ1310 )
English text: YES
No
English text: NO
Attribute
Don't know
Route
BOX IP4A - (IPQ1310 )
Refusal
BOX IP4A - (IPQ1310 )
BOX IP4A - (IPQ1310 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
9:57:08 AM Friday, March 06, 2009
Page 62 of 79
BOX IP4A
BOX IP4A
Page Order # :
220
BOX INSTRUCTIONS
( IPQ1310 )
IF CURRENTLY ADMINISTERING ST, GO TO BOX ST23B - (STQ1700 ).
ELSE IF CURRENTLY ADMINISTERING NS, GO TO BOX NS23B (NSQ1700 ).
ELSE IF SP IS IN THE EXIT SAMPLE AND PREVIOUS ROUND INTERVIEW
NOT SKIPPED, GO TO BOX IP6 - (IPQ1400 ).
ELSE GO TO IP13 - PRESMDCN ( IPQ1320 ).
ASSIGNMENTS
TECHNICAL NOTES
19
ExitNotSkip
If SP is in the Exit Sample and previous round interview
not skipped =
MRES.INTTYPE=8/ExitInterviewHadPrev on MRES
where MRES.MRESRND = current round.
DESIGN NOTES
If administering ST or NS, we do not collect prescription medicines for IP
stay. BOX IP4A is routed back to BOX ST23B or BOX NS23B.
If the SP is in the exit sample and previous round interview was not
skipped (MRES.INTTYPE=8/ExitInterviewHadPrev), we do not collect
prescription medicines for the IP stay. BOX IP4A is routed to the end of
IP.
9:57:08 AM Friday, March 06, 2009
Page 63 of 79
IP13
IP13
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
PRESMDCN
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
230
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Display admission date,
EVNT.EVBEGMM/EVNT.EVBEGDD/EVNT.EVBEGYY.
Display discharge date,
EVNT.EVENDMM/EVNT.EVENDDD/EVNT.EVENDYY.
Question display:
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
DATES OF HOSPITAL STAY: (ADMISSION DATE) - (DISCHARGE
DATE)
Int. Instr I:
Question Text:
At the time [you were /(SP) was] discharged, were any medicines
prescribed for [you/(SP)]?
Int. Instr II:
9:57:10 AM Friday, March 06, 2009
Page 64 of 79
IP13
INPUT FIELDS / ROUTING
PRESMDCN
Field1:
Cheshire Name:
( IPQ1320 )
EVNT.PRESMDCN
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP14 - PRESFILL ( IPQ1330 )
English text: YES
No
English text: NO
Attribute
Don't know
Route
BOX IP5 - (IPQ1370 )
Refusal
BOX IP5 - (IPQ1370 )
BOX IP5 - (IPQ1370 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
9:57:12 AM Friday, March 06, 2009
Page 65 of 79
IP14
IP14
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
PRESFILL
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
240
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
Were any of the prescriptions filled?
Int. Instr II:
INPUT FIELDS / ROUTING
9:57:13 AM Friday, March 06, 2009
Page 66 of 79
IP14
PRESFILL
Field1:
Cheshire Name:
( IPQ1330 )
EVNT.PRESFILL
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
BOX IP4B - (IPQ1340 )
English text: YES
No
BOX IP5 - (IPQ1370 )
English text: NO
Attribute
Don't know
Route
BOX IP5 - (IPQ1370 )
Refusal
BOX IP5 - (IPQ1370 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
9:57:15 AM Friday, March 06, 2009
Page 67 of 79
BOX IP4B
BOX IP4B
Page Order # :
250
BOX INSTRUCTIONS
( IPQ1340 )
IF THE PROBE FOR PRESCRIPTION MEDICINE BOTTLES HAS NOT BEEN
ASKED IN THE CURRENT ROUND, GO TO IP14A - IPPMMEDS ( IPQ1350 ).
ELSE GO TO IP15 - MEDICINE_IP ( IPQ1360 ).
ASSIGNMENTS
TECHNICAL NOTES
131
PMBottleProbe
Prescription Medicine Bottle probe has been asked in the
current round =
GETPMMEDS=1/Yes.
DESIGN NOTES
Only probe for prescription medicine bottles once during the current
round.
Adding a new TEMP flag, GETPMMEDS. GETPMMEDS is set to 1/Yes
whenever the Prescription Bottle probe is asked during the current
round. This will get set anywhere in utilization or cost series.
9:57:15 AM Friday, March 06, 2009
Page 68 of 79
IP14A
IP14A
Page Order # :
Design Screen Type:
No Entry
Fields:
Field 1:
IPPMMEDS
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
260
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Always display "(s)" in "bottle(s), container(s), or bag(s)" in
parenthesis.
Display "[IF RESPONDENT HAS BOTTLE, ASK:]" in same blue font
used for interviewer instructions.
If SP has a "current" Medicare Prescription Drug plan or there was a
Medicare Prescription Drug plan "current" at the time of the
previous round interview, then display "Also, please take out
[your/(SP's)] (MEDICARE PRESCRIPTION DRUG PLAN NAME)
medicine statements....".
Else do not display.
MEDICARE PRESCRIPTION DRUG PLAN NAME =
Display the name of the "current" Medicare Prescription Drug plan.
If it does not exist, display the name of the Medicare Prescription
Drug plan "current" at the time of the previous round interview.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
9:57:17 AM Friday, March 06, 2009
Page 69 of 79
IP14A
TEXT:
Context Header:
Int. Instr I:
It would be helpful if I could look at any medicine bottle(s),
container(s), or bag(s) that you have so that I can spell the medicine
name correctly and enter the strength of the medicine. [Also, please
take out [your/(SP's)] (MEDICARE PRESCRIPTION DRUG PLAN
NAME) medicine statements, which should have that same
information on them.]
Question Text:
[IF RESPONDENT HAS BOTTLE, ASK:] I’ll need that same
information for all of the medicines [you/(SP)] obtained since the last
interview, if you’d like to get those bottles, too.
Int. Instr II:
INPUT FIELDS / ROUTING
IPPMMEDS
Field1:
Cheshire Name:
( IPQ1350 )
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TContinueEMPTY
1
No
No
Number Label
1 Continue
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP15 - MEDICINE_IP ( IPQ1360 )
English text: CONTINUE
Attribute
Empty
Route
IP15 - MEDICINE_IP ( IPQ1360 )
BACKGROUND VARIABLE ASSIGNMENTS
The question displayed at IP14A is repeated in other utilization sections. Only show this
probe for prescription medicine bottles once during the current round interview.
If IP14A - IPPMMEDS is asked, set flag as instructed below:
GETPMMEDS
9:57:19 AM Friday, March 06, 2009
Set GETPMMEDS=1/Yes.
Page 70 of 79
IP14A
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
342
MPDPCurrent
SP has a "current" Medicare Prescription Drug plan =
There is a PLAN where PLAN.PLANTYPE=7/MPDP &
PLRO where (PLRO.PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=current round &
PLRO.COVCURNT=1/Yes).
Exclude Deleted Plans. See T.N. 52.
343
MPDPCurrPrevRnd
Medicare Prescription Drug plan "current" at time of
previous round interview=
There is a PLAN where PLAN.PLANTYPE=7/MPDP &
PLRO where (PLROPLAN=PLAN.PLANNUM &
PLRO.PLRORND=previous round &
PLRO.COVCURNT=1/Yes).
Exclude Deleted Plans. See T.N. 52.
DESIGN NOTES
9:57:19 AM Friday, March 06, 2009
Page 71 of 79
IP15
IP15
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
MEDICINE_IP
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Name:
Prescription Medicine Roster
Roster Type:
Multiple Item Select
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
Yes
Yes
No
No
Grid Functions:
Add Line
Delete Line
No
No
270
Display as ' Add a Medicine '
Display as ' Edit a Medicine '
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display"CHECK STATEMENT OR MEDICINE BOTTLE FOR
SPELLING." in BOLD.
Display "INCLUDE STRENGTH WITH NAME." in BOLD.
Multi Field display:
Roster/Grid Instructions:
Display all Prescription Medicine events where:
EVNT.EVNTDFLG ^=1/Yes, and
EVNT.EVNTTYPE='PM'.
Display in alphabetical order.
Roster/Grid display:
COL #
HEADER
INSTRUCTIONS
1
Medicine
Display prescription medicine name,
EVNT.PMEDNAME.
2
Strength
Display prescription medicine strength
text field, EVNT.PMSTRUNI.
Report display:
TEXT:
Context Header:
9:57:19 AM Friday, March 06, 2009
Page 72 of 79
IP15
Int. Instr I:
Question Text:
Please tell me the names of these medicines.
Int. Instr II:
ENTER ALL MEDICINES.
CHECK STATEMENT OR MEDICINE BOTTLE FOR SPELLING.
INCLUDE STRENGTH WITH NAME.
INPUT FIELDS / ROUTING
MEDICINE_IP
Field1:
( IPQ1360 )
TEMP
Cheshire Name:
Item Text display:
Item Text:
Label:
Label Position:
String
TEvntPick135
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
1
No
No
Number Label
1 [Continuous answer.]
FieldSize:
Min Value:
Max Value:
Mask:
135
Route
BOX IP5 - (IPQ1370 )
BACKGROUND VARIABLE ASSIGNMENTS
Roster details will be collected on EVNT:
EVNT key = EVNT.EVNTBASE + EVNT.EVNTNUM
EVNT.EVNTNUM = Number of PM event selected at IP15.
If Prescription Medicine added at Prescription Medicine Roster, see PRESCRIPTION
MEDICINE ROSTER POP-UP specifications for pop-up window programming instructions.
Variables populated at the Prescription Medicine Roster:
EVNT.EVNTNUM
EVNT.EVNTRNDC
EVNT.EVNTTYPE
EVNT.PMEDNAME
EVNT.PMSTRUNI
EVNT.EVNTPROV
BASE.LASTEVNT
Event number
Round number
PM
Prescription Medicine name
Prescription Medicine strength text field
02
Highest EVNT.EVNTNUM
For all Prescription Medicines selected at IP15, create a current round PMRO. Note: a
current round PMRO may already exist for a Prescription Medicine event if it has already
been selected earlier in the interview.
9:57:20 AM Friday, March 06, 2009
Page 73 of 79
IP15
PMRO key = PMRO.PMROBASE + PMRO.PMROEVNT + PMRO.PMRORND.
Create PMRO where PMRO.PMROEVNT = EVNT.EVNTNUM for prescription medicine
selected and PMRO.PMRORND = current round. Set additional PMRO variable as
instructed below.
All prescription medicines selected at IP15 should be linked to the Inpatient stay being
asked about. Prescription medicine events are linked to other events on XMED.
XMED key = XMED.XMEDBASE + XMED.XMEDEVNT + XMED.XMEDBAS2 +
XMED.XMEDEVT2.
For each medicine selected at IP15, create an XMED where XMEDEVNT =
EVNT.EVNTNUM of Inpatient stay visit being asked about and XMEDEVT2 =
EVNT.EVNTNUM of Prescription Medicine selected at IP15. XMEDBASE and
XMEDBAS2 both equal the Cheshire BASE.BASEID. Set additional XMED variables as
specified below.
Set the following PMRO and XMED variables for each prescription medicine selected at
IP15:
PMROEVNT
PMRO.PMROEVNT = EVNT.EVNTNUM of
prescription medicine selected at IP15.
PMRORND
PMRO.PMRORND = current round.
PMROTYPE
PMRO.PMROTYPE='PM'.
XMEDEVNT
XMED.XMEDEVNT=EVNT.EVNTNUM of Inpatient
stay being asked about.
XMEDEVT2
XMED.XMEDEVT2=EVNT.EVNTNUM of prescription
medicine selected at IP15.
XMEDRNDC
XMED.XMEDRNDC = current round.
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
9:57:20 AM Friday, March 06, 2009
Page 74 of 79
BOX IP5
BOX IP5
Page Order # :
280
BOX INSTRUCTIONS
( IPQ1370 )
IF ASKING ABOUT ONGOING IP STAY FROM THE PREVIOUS ROUND, GO
TO BOX IP1AB - (IPQ1016 ).
ELSE IF ASKING ABOUT AN EMERGENCY ROOM VISIT IN THE CURRENT
ROUND THAT RESULTED IN AN IP STAY, THEN .
IF SP HAS ANOTHER EMERGENCY ROOM VISIT IN THE CURRENT
ROUND THAT RESULTED IN AN IP STAY THAT HAS NOT BEEN ASKED
ABOUT, GO TO BOX IP1AA - (IPQ1017 ).
ELSE GO TO IP1 - IPPROBE ( IPQ1025 ).
ELSE GO TO IP16 - IPMORE ( IPQ1380 ).
ASSIGNMENTS
TECHNICAL NOTES
138
ERtoIPStay
SP had an emergency room visit in the current round that
resulted in the SP being admitted to hospital =
There is an EVNT where EVNT.EVNTDFLG^=1/Yes and
EVNT.EVNTRNDC=current round and
EVNT.EVNTTYPE='ER' and EVNT.ERADMIT=1/Yes and
EVNT.EVUTSFLG ^=1/Yes.
DESIGN NOTES
9:57:20 AM Friday, March 06, 2009
Page 75 of 79
IP16
IP16
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
IPMORE
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
290
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
If SP is deceased or institutionalized, display "did (SP) have".
Else if proxy interview, display "has (SP) had".
Else display "have you had".
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
IF RESPONDENT HAS ALREADY MENTIONED ANOTHER
INPATIENT STAY, ENTER “YES” WITHOUT ASKING.
OTHERWISE, ASK:
Question Text:
[Since (REFERENCE DATE)/Between (REFERENCE DATE) and
(DATE OF DEATH/DATE OF INSTITUTIONALIZATION)], [have you
had/has (SP) had/did (SP) have] any other admissions to this or any
other hospital as an inpatient -- either for an overnight stay or for a
"same day" procedure?
Int. Instr II:
IF HAD SAME DAY PROCEDURE AND IS NOT SURE IF
9:57:22 AM Friday, March 06, 2009
Page 76 of 79
IP16
ADMITTED OR NOT, TREAT AS OUTPATIENT EVENT AND
ENTER WHEN YOU GET TO OP UTILIZATION.
INPUT FIELDS / ROUTING
( IPQ1380 )
IPMORE
Field1:
Cheshire Name:
TEMP
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TYesNoDKRF
1
No
No
Number Label
1 Yes
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
IP2 - PROVIDER_IP ( IPQ1030 )
English text: YES
No
BOX IP6 - (IPQ1400 )
English text: NO
Attribute
Don't know
Route
BOX IP6 - (IPQ1400 )
Refusal
BOX IP6 - (IPQ1400 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
59
SPStatus
SP is Alive and not institutionalized =
MRES.SPALIVE=1/Alive or empty
SP is Alive =
MRES.SPALIVE=1/Alive, 2/AliveAndInstitute, or EMPTY
9:57:24 AM Friday, March 06, 2009
Page 77 of 79
IP16
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
DESIGN NOTES
9:57:24 AM Friday, March 06, 2009
Page 78 of 79
BOX IP6
BOX IP6
Page Order # :
310
BOX INSTRUCTIONS
( IPQ1400 )
GO TO NEXT SECTION .
ASSIGNMENTS
TECHNICAL NOTES
DESIGN NOTES
9:57:24 AM Friday, March 06, 2009
Page 79 of 79
| File Type | application/pdf |
| Author | hubbard_r |
| File Modified | 2010-04-05 |
| File Created | 0000-00-00 |