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OP1
OP1
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
OPPROBE
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 "did (SP) go".
Else if proxy interview, display "has (SP) gone".
Else display "have you gone".
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
[Since (REFERENCE DATE)/Between (REFERENCE DATE) and
(DATE OF DEATH/DATE OF INSTITUTIONALIZATION)], [have you
gone/has (SP) gone/did (SP) go] to the outpatient department or the
outpatient clinic at any hospital for medical care?
Int. Instr II:
INPUT FIELDS / ROUTING
10:56:41 AM Friday, March 06, 2009
Page 1 of 52
OP1
( OPQ1020 )
OPPROBE
Field1:
Cheshire Name:
Item Text display:
HRND.OPPROBE
Do not display response option 3/IndicatedYesByDataprep.
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TProbe
FieldSize:
Min Value:
Max Value:
Mask:
1
No
No
Number Label
1 Yes
Route
OP2 - PROVIDER_OP ( OPQ1030 )
2
English text: YES
No
3
English text: NO
IndicatedYesByDataPrep
BOX OP7 - (OPQ1505 )
DO NOT DISPLAY. DATA EDITING ONLY.
English text: INDICATED YES BY DATAPREP
Attribute
Don't know
Route
BOX OP7 - (OPQ1505 )
Refusal
BOX OP7 - (OPQ1505 )
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
10:56:44 AM Friday, March 06, 2009
Page 2 of 52
OP1
SP is Institutionalized =
MRES.SPALIVE=2/AliveAndInstitute
SP is Deceased =
MRES.SPALIVE=3/Deceased.
4
Respondent
On MRES where MRES.MRESRND = current round:
A Proxy interview (respondent is a proxy) =
MRES.SPPROXY=2/Proxy.
MRES.RROSTNUM=ROST.ROSTNUM of respondent.
An SP interview (respondent is the SP) =
MRES.SPPROXY=1/SP.
MRES.RROSTNUM='01'.
DESIGN NOTES
10:56:44 AM Friday, March 06, 2009
Page 3 of 52
OP2
OP2
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
PROVIDER_OP
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:
Always display "(to which hospital)" in parenthesis.
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:
Int. Instr I:
Question Text:
Where did [you/(SP)] go (to which hospital)?
Int. Instr II:
SELECT OR ADD ONLY ONE HOSPITAL.
INPUT FIELDS / ROUTING
10:56:45 AM Friday, March 06, 2009
Page 4 of 52
OP2
PROVIDER_OP
Field1:
( OPQ1030 )
PROV.PROVNAME
Cheshire Name:
Item Text display:
Item Text:
Label:
Label Position:
String
TProvPick4
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:
4
Route
BOX OP1 - (OPQ1050 )
BACKGROUND VARIABLE ASSIGNMENTS
Roster details will be collected on PROV:
PROV key = PROV.PROVBASE + PROV.PROVNUM
PROV.PROVNUM = Number of Provider selected at OP2.
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
Provider name
If Provider added, set provider type as instructed below:
PROVTYPE
PROV.PROVTYPE = 4/OutpatientHospital.
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
Begin Loop 1: Probe for one provider, collect all event dates for this
provider.
10:56:45 AM Friday, March 06, 2009
Page 5 of 52
BOX OP1
BOX OP1
Page Order # :
40
BOX INSTRUCTIONS
( OPQ1050 )
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 OP3 VAPLACE ( OPQ1060 ).
ELSE GO TO BOX OP1B - (OPQ1070 ).
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
10:56:45 AM Friday, March 06, 2009
Page 6 of 52
OP3
OP3
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 the name of the 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
10:56:47 AM Friday, March 06, 2009
Page 7 of 52
OP3
VAPLACE
Field1:
Cheshire Name:
( OPQ1060 )
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 OP1B - (OPQ1070 )
English text: YES
No
BOX OP1B - (OPQ1070 )
English text: NO
Attribute
Don't know
Route
BOX OP1B - (OPQ1070 )
Refusal
BOX OP1B - (OPQ1070 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
10:56:49 AM Friday, March 06, 2009
Page 8 of 52
BOX OP1B
BOX OP1B
10:56:49 AM Friday, March 06, 2009
Page Order # :
60
Page 9 of 52
BOX OP1B
BOX INSTRUCTIONS
( OPQ1070 )
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 OP3A - HMOASSOC (
OPQ1080 ).
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 OP3B - HMOREFER ( OPQ1090 ).
ELSE GO TO OP4 - EVENT_OP ( OPQ1130 ).
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 OP1B is routed to OP3A
HMOASSOC. If we have already asked this question about this provider,
and the provider responded to HMOASSOC=No, DK or RF, BOX OP1B is
routed to OP3B, skipping OP3A, 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 OP1B routes directly to OP4, collects
outpatient stays, skipping OP3A and OP3B.
10:56:49 AM Friday, March 06, 2009
Page 10 of 52
OP3A
OP3A
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 the name of the 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:
10:56:50 AM Friday, March 06, 2009
Page 11 of 52
OP3A
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:
( OPQ1080 )
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
OP4 - EVENT_OP ( OPQ1130 )
English text: YES
No
OP3B - HMOREFER ( OPQ1090 )
English text: NO
Attribute
Don't know
Route
OP3B - HMOREFER ( OPQ1090 )
Refusal
OP3B - HMOREFER ( OPQ1090 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
52
DeletedPlans
10:56:53 AM Friday, March 06, 2009
Deleted plans that are not valid for displays or checks =
Page 12 of 52
OP3A
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
10:56:53 AM Friday, March 06, 2009
Page 13 of 52
OP3B
OP3B
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 the name of the 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:
10:56:55 AM Friday, March 06, 2009
Page 14 of 52
OP3B
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:
( OPQ1090 )
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
OP4 - EVENT_OP ( OPQ1130 )
English text: YES
No
OP3D - NOGOHMO ( OPQ1100 )
English text: NO
Attribute
Don't know
Route
OP4 - EVENT_OP ( OPQ1130 )
Refusal
OP4 - EVENT_OP ( OPQ1130 )
BACKGROUND VARIABLE ASSIGNMENTS
OP3B - HMOREFER is an EVENT level detail. The response to OP3B - HMOREFER
needs to be copied to EVNT.HMOREFER for each OP Event added at OP4.
SOFT EDIT CHECKS
HARD EDIT CHECKS
10:56:58 AM Friday, March 06, 2009
Page 15 of 52
OP3B
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.
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
10:56:58 AM Friday, March 06, 2009
Page 16 of 52
OP3D
OP3D
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:
10:57:00 AM Friday, March 06, 2009
Page 17 of 52
OP3D
Question Text:
What is the most important reason [you/(SP)] did not go to a hospital
outpatient department associated with [READ MANAGED CARE
PLAN NAME(S) BELOW] or a hospital outpatient department 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
10:57:05 AM Friday, March 06, 2009
Page 18 of 52
OP3D
NOGOHMO
Field1:
Cheshire Name:
Item Text display:
( OPQ1100 )
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
OP4 - EVENT_OP ( OPQ1130 )
English text: PLAN DOES NOT COVER THE SERVICE SP WANTED
DifficultyDelayGettingService
OP4 - EVENT_OP ( OPQ1130 )
4
English text: DIFFICULTY OR DELAY IN GETTING SERVICES
SPProviderPreference
OP4 - EVENT_OP ( OPQ1130 )
English text: SP PROVIDER PREFERENCE
ServiceCoverdbyOtherInsurance
OP4 - EVENT_OP ( OPQ1130 )
5
English text: THIS SERVICE WAS COVERED BY OTHER INSURANCE SP HAS
NotinManagedCareTimeofEvent
OP4 - EVENT_OP ( OPQ1130 )
6
English text: NOT IN A MANAGED CARE PLAN AT TIME OF EVENT
NoChoiceMedEmergency
OP4 - EVENT_OP ( OPQ1130 )
3
91
English text: NO CHOICE - MEDICAL EMERGENCY OR OUT OF SERVICE AREA
Other
OP3D - NOGOHMOS ( OPQ1110 )
English text: OTHER
Attribute
Don't know
Route
OP4 - EVENT_OP ( OPQ1130 )
Refusal
OP4 - EVENT_OP ( OPQ1130 )
10:57:12 AM Friday, March 06, 2009
Page 19 of 52
OP3D
NOGOHMOS
Field2:
Cheshire Name:
( OPQ1110 )
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
OP4 - EVENT_OP ( OPQ1130 )
BACKGROUND VARIABLE ASSIGNMENTS
OP3D - NOGOHMO and NOGOHMOS are EVENT level details. The response to OP3D
NOGOHMO and NOGOHMOS needs to be copied to EVNT.NOGOHMO and
EVNT.NOGOHMOS for each OP Event added at OP4.
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.
10:57:13 AM Friday, March 06, 2009
Page 20 of 52
OP3D
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
10:57:13 AM Friday, March 06, 2009
Page 21 of 52
OP4
OP4
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
EVENT_OP
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
Yes
Yes
Roster Name:
Event Roster Begin Date RV
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
110
Display as ' Add Outpatient Department Visit '
Display as ' Edit Visit '
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display the name of the hospital, PROV.PROVNAME, currently
being asked about.
Multi Field display:
Roster/Grid Instructions:
Display all Outpatient Hospital Events for this provider that have
been added in the current round where:
EVNT.EVNTDFLG ^= 1/Yes, and
EVNT.EVNTRNDC = current round, and
EVNT.EVNTTYPE = 'OP', and
EVNT.EVNTPROV=PROV.PROVNUM for the provider selected at
OP2.
Display all loaded events as protected rows.
Display in order of entry.
Roster/Grid display:
10:57:14 AM Friday, March 06, 2009
COL #
HEADER
INSTRUCTIONS
1
Event Date
Display EVENT DATE in "Mon DD YYYY"
format.
2
Repeat Visit
If VISTTYPE=2/RepeatVisit, display "RV".
Else do not display.
3
Times Per Month
If VISTTYPE=2/RepeatVisit, display
EVNT.RVTIMES.
Else do not display.
Page 22 of 52
OP4
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
When did [you/(SP)] go to an outpatient department at (HOSPITAL
NAME)? Please tell me all the dates [since (REFERENCE
DATE)/between (REFERENCE DATE) and (DATE OF DEATH/DATE
OF INSTITUTIONALIZATION)].
Int. Instr II:
ENTER ALL DATES.
INPUT FIELDS / ROUTING
EVENT_OP
Field1:
( OPQ1130 )
EVNT.EVBEGMM
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
OP4_IN - NAVIGATOR ( OPQ1135 )
BACKGROUND VARIABLE ASSIGNMENTS
Roster details will be collected on EVNT:
EVNT key = EVNT.EVNTBASE + EVNT.EVNTNUM
EVNT.EVNTNUM = Number of event selected at OP4.
For Event(s) added, see EVENT ROSTER BEGIN DATE RV POP-UP specifications for
pop-up window programming instructions.
Variables populated in Event Roster Begin Date RV:
EVNT.EVNTNUM
EVNT.EVNTRNDC
EVNT.EVBEGMM
EVNT.EVBEGDD
EVNT.EVBEGYY
Event number
Round
Visit Month
Visit Day
Visit Year
10:57:14 AM Friday, March 06, 2009
Page 23 of 52
OP4
EVNT.VISTTYPE
EVNT.RVTIMES
BASE.LASTEVNT
Type of Visit
# of visits for Repeat Visit
Highest EVNT.EVNTNUM
For each event added at OP4, set Event type, Statement Event type, Event provider
number, and Event details collected at OP3B and OP3D. See detailed instructions below.
EVNTTYPE
EVNT.EVNTTYPE = 'OP'.
STEVTYPE
EVNT.STEVTYPE = 6/OP.
EVNTPROV
EVNT.EVNTPROV=PROV.PROVNUM of hospital
selected at OP2.
HMOREFER
EVNT.HMOREFER = Response to OP3B HMOREFER.
NOGOHMO
EVNT.NOGOHMO = Response to OP3D NOGOHMO.
NOGOHMOS
EVNT.NOGOHMOS = Response to OP3D NOGOHMOS.
SOFT EDIT CHECKS
HARD EDIT CHECKS
Edit #1:
Date of event, 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. DATE MUST BE ON
OR BETWEEN (REFERENCE DATE) AND (TODAY/DATE OF
DEATH/DATE OF INSTITUTIONALIZATION)".
See date check logic in general specifications.
Edit #2:
Date of event, EVBEGMM/EVBEGDD/EVBEGYY, cannot match an
existing OP event date for the provider selected at OP2. If date of
event added at OP4 does not have missing data, EVBEGMM,
EVBEGDD, EVBEGYY ^= DK and EVBEGMM, EVBEGDD,
EVBEGYY ^= RF, then check this date against other OP event dates
for duplicate dates.
The following must be true for the event added at OP4 to be a
duplicate of an existing event:
Both EVNTDFLG ^= 1/Yes.
Both EVNTRNDC=current round.
Both EVNTTYPE=OP.
EVNTPROV matches.
EVBEGMM matches.
If EVBEGDD ^= empty, EVBEGDD matches.
Else If EVBEGDD = empty, both VISTTYPE=2/RepeatVisit.
EVBEGYY matches.
The date of the event added at OP4 should not match any OP event
date for the provider selected at OP2.
If not true, display message "INVALID DATE. THIS DATE
MATCHES AN EXISTING OUTPATIENT VISIT TO (HOSPITAL
NAME).
Display instructions: Display hospital name, PROV.PROVNAME,
10:57:14 AM Friday, March 06, 2009
Page 24 of 52
OP4
selected at OP2.
TECHNICAL NOTES
DESIGN NOTES
Begin Loop 2: Collect all event dates for this provider, loop through details
for each event added at OP4.
OP allows you to select a provider more than once at OP2. If this provider
has already been selected and visits added at OP4 in an earlier loop, the
visits will be displayed at OP4 as protected rows.
10:57:15 AM Friday, March 06, 2009
Page 25 of 52
OP4_IN
OP4_IN
Page Order # :
Design Screen Type:
Instance Navigator
Fields:
Field 1:
NAVIGATOR
Enable Functions:
HELP
COMMENTS
JUMPBACK
No
No
No
115
Roster Name:
Roster Type:
Roster Functions:
Add Item
Edit Item
Delete Item
Search Item
No
No
No
No
Grid Functions:
Add Line
Delete Line
No
No
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display events added at OP4.
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
Int. Instr II:
INPUT FIELDS / ROUTING
10:57:15 AM Friday, March 06, 2009
Page 26 of 52
OP4_IN
NAVIGATOR
Field1:
Cheshire Name:
( OPQ1135 )
N/A
Item Text display:
Item Text:
Label:
Label Position:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:
Enumerated
TInstanceNavigator
1
No
No
Number Label
1 SelectItemInList
2
FieldSize:
Min Value:
Max Value:
Mask:
Route
OP5 - ANYOPERS ( OPQ1160 )
English text: ITEM SELECTED IN INSTANCE NAVIGATOR
SelectContinueInterview
OP15 - OPMORE ( OPQ1330 )
English text: CONTINUE INTERVIEW SELECTED
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
10:57:17 AM Friday, March 06, 2009
Page 27 of 52
OP5
OP5
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
120
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Question display:
Display date of event for the Outpatient Department visit currently
being asked about.
If event entered as a Repeat Visit then display "any of the".
Else display "the".
If OP5 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:
10:57:18 AM Friday, March 06, 2009
Were any operations or other surgical procedures performed on
[you/(SP)] during (any of the/the) [VISIT ON EVENT DATE]?
Page 28 of 52
OP5
[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
( OPQ1160 )
ANYOPERS
Field1:
Cheshire Name:
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
OP9 - CONDITION_OP ( OPQ1210 )
English text: YES
No
OP8 - SPECCOND ( OPQ1200 )
English text: NO
Attribute
Don't know
Route
OP8 - SPECCOND ( OPQ1200 )
Refusal
OP8 - SPECCOND ( OPQ1200 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
136
NumberRepeatVisits
10:57:21 AM Friday, March 06, 2009
Number of Repeat Visits =
Page 29 of 52
OP5
EVNT.RVTIMES.
135
RepeatVisitEvent
If Event entered as a Repeat Visit =
EVNT.VISTTYPE=2/RepeatVisit.
DESIGN NOTES
OP5 is called by BOX ST22A or BOX NS22A when an Outpatient Hospital
visit has been added. OP collects the event details and returns to the ST or
NS at BOX OP2A.
10:57:21 AM Friday, March 06, 2009
Page 30 of 52
OP8
OP8
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
160
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Display date of event for the Outpatient Department visit currently
being asked about.
Question display:
If event entered as a Repeat Visit, display "Were any of these visits".
Else display "Was this visit".
Multi Field display:
Display all input fields at one time.
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
DATE OF OUTPATIENT DEPARTMENT VISIT: [VISIT ON EVENT
DATE]
Int. Instr I:
Question Text:
(Was this visit/Were any of these visits) to the outpatient department
for any specific condition?
Int. Instr II:
INPUT FIELDS / ROUTING
10:57:22 AM Friday, March 06, 2009
Page 31 of 52
OP8
SPECCOND
Field1:
Cheshire Name:
( OPQ1200 )
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
OP9 - CONDITION_OP ( OPQ1210 )
English text: YES
No
BOX OP2A - (OPQ1220 )
English text: NO
Attribute
Don't know
Route
BOX OP2A - (OPQ1220 )
Refusal
BOX OP2A - (OPQ1220 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
10:57:25 AM Friday, March 06, 2009
Page 32 of 52
OP9
OP9
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
CONDITION_OP
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
170
Display as ' Add a Condition '
Display as ' Edit a Condition '
DISPLAY INSTRUCTIONS:
Context header display:
Display date of event for the Outpatient Department visit currently
being asked about.
Question display:
If OP5 = 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:
Report display:
TEXT:
Context Header:
DATE OF OUTPATIENT DEPARTMENT VISIT: [VISIT ON EVENT
DATE]
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
10:57:25 AM Friday, March 06, 2009
Page 33 of 52
OP9
Field1:
Cheshire Name:
CONDITION_OP
( OPQ1210 )
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
BOX OP2A - (OPQ1220 )
BACKGROUND VARIABLE ASSIGNMENTS
Conditions will be collected on COND:
COND key = COND.CONDBASE + COND.CONDNUM
COND.CONDNUM = Number of condition selected at OP9.
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 OP9 should be linked to the Outpatient Department visit being
asked about. Link Conditions to OP visit on XCON.
XCON key = XCON.XCONBASE + XCON.XCONEVNT + XCON.XCONBAS2 +
XCON.XCONCOND.
For each condition selected at OP9, create an XCON where XCONEVNT=
EVNT.EVNTNUM of Outpatient Department visit and XCONCOND = COND.CONDNUM of
Condition. XCONBASE and XCONBAS2 both equal the Cheshire BASE.BASEID. Set
additional XCON variables as specified below.
XCONEVNT
XCON.XCONEVNT = EVNT.EVNTNUM of
Outpatient Deparment visit being asked about.
XCONCOND
XCON.XCONCOND = COND.CONDNUM of
condition selected at OP9.
XCONRNDC
XCON.XCONRNDC = current round.
SOFT EDIT CHECKS
10:57:26 AM Friday, March 06, 2009
Page 34 of 52
OP9
HARD EDIT CHECKS
TECHNICAL NOTES
135
RepeatVisitEvent
If Event entered as a Repeat Visit =
EVNT.VISTTYPE=2/RepeatVisit.
DESIGN NOTES
10:57:26 AM Friday, March 06, 2009
Page 35 of 52
BOX OP2A
BOX OP2A
Page Order # :
180
BOX INSTRUCTIONS
( OPQ1220 )
IF CURRENTLY ADMINISTERING ST, GO TO BOX ST23B - (STQ1700 ).
ELSE IF CURRENTLY ADMINISTERING NS, GO TO BOX NS23A (NSQ1695 ).
ELSE GO TO OP10 - PRESMDCN ( OPQ1230 ).
ASSIGNMENTS
TECHNICAL NOTES
DESIGN NOTES
If administering ST or NS, return to BOX ST23A or BOX NS23A.
10:57:26 AM Friday, March 06, 2009
Page 36 of 52
OP10
OP10
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
190
Roster Name:
Roster Type:
DISPLAY INSTRUCTIONS:
Context header display:
Display date of event for the Outpatient Department visit currently
being asked about.
Question display:
If event entered as a Repeat Visit, display "any of these visits".
Else display "this visit".
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
DATE OF OUTPATIENT DEPARTMENT VISIT: [VISIT ON EVENT
DATE]
Int. Instr I:
Question Text:
During (this visit/any of these visits) to the outpatient department,
were any medicines prescribed for [you/(SP)]?
Int. Instr II:
INPUT FIELDS / ROUTING
10:57:27 AM Friday, March 06, 2009
Page 37 of 52
OP10
PRESMDCN
Field1:
Cheshire Name:
( OPQ1230 )
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
OP11 - PRESFILL ( OPQ1240 )
English text: YES
No
BOX OP3 - (OPQ1280 )
English text: NO
Attribute
Don't know
Route
BOX OP3 - (OPQ1280 )
Refusal
BOX OP3 - (OPQ1280 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
10:57:29 AM Friday, March 06, 2009
Page 38 of 52
OP11
OP11
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
200
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
10:57:31 AM Friday, March 06, 2009
Page 39 of 52
OP11
PRESFILL
Field1:
Cheshire Name:
( OPQ1240 )
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 OP2B - (OPQ1250 )
English text: YES
No
BOX OP3 - (OPQ1280 )
English text: NO
Attribute
Don't know
Route
BOX OP3 - (OPQ1280 )
Refusal
BOX OP3 - (OPQ1280 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
10:57:33 AM Friday, March 06, 2009
Page 40 of 52
BOX OP2B
BOX OP2B
Page Order # :
210
BOX INSTRUCTIONS
( OPQ1250 )
IF THE PROBE FOR PRESCRIPTION MEDICINE BOTTLES HAS NOT BEEN
ASKED IN THE CURRENT ROUND, GO TO OP11A - OPPMMEDS (
OPQ1260 ).
ELSE GO TO OP12 - MEDICINE_OP ( OPQ1270 ).
ASSIGNMENTS
TECHNICAL NOTES
131
PMBottleProbe
Prescription Medicine Bottle probe has been asked in the
current round =
GETPMMEDS=1/Yes.
DESIGN NOTES
10:57:33 AM Friday, March 06, 2009
Page 41 of 52
OP11A
OP11A
Page Order # :
Design Screen Type:
No Entry
Fields:
Field 1:
OPPMMEDS
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
220
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:
10:57:34 AM Friday, March 06, 2009
Page 42 of 52
OP11A
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
OPPMMEDS
Field1:
Cheshire Name:
( OPQ1260 )
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
OP12 - MEDICINE_OP ( OPQ1270 )
English text: CONTINUE
Attribute
Empty
Route
OP12 - MEDICINE_OP ( OPQ1270 )
BACKGROUND VARIABLE ASSIGNMENTS
The question displayed at OP11A is repeated in other utilization sections. Only show this
probe for prescription medicine bottles once during the current round interview.
If OP11A - OPPMMEDS is asked, set flag as instructed below:
GETPMMEDS
10:57:36 AM Friday, March 06, 2009
Set GETPMMEDS = 1/Yes.
Page 43 of 52
OP11A
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
10:57:36 AM Friday, March 06, 2009
Page 44 of 52
OP12
OP12
Page Order # :
Design Screen Type:
Roster
Fields:
Field 1:
MEDICINE_OP
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
230
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:
10:57:37 AM Friday, March 06, 2009
Page 45 of 52
OP12
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_OP
Field1:
( OPQ1270 )
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 OP3 - (OPQ1280 )
BACKGROUND VARIABLE ASSIGNMENTS
Roster details will be collected on EVNT:
EVNT key = EVNT.EVNTBASE + EVNT.EVNTNUM
EVNT.EVNTNUM = Number of PM event selected at OP12.
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 OP12, 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.
10:57:38 AM Friday, March 06, 2009
Page 46 of 52
OP12
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 OP12 should be linked to the Outpatient Department
visit 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 OP12, create an XMED where XMEDEVNT =
EVNT.EVNTNUM of Outpatient Department visit being asked about and XMEDEVT2 =
EVNT.EVNTNUM of Prescription Medicine selected at OP12. 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
OP12:
PMROEVNT
PMRO.PMROEVNT = EVNT.EVNTNUM of
prescription medicine selected at OP12.
PMRORND
PMRO.PMRORND = current round.
PMROTYPE
PMRO.PMROTYPE = PM.
XMEDEVNT
XMED.XMEDEVNT = EVNT.EVNTNUM of
Outpatient Department visit being asked about.
XMEDEVT2
XMED.XMEDEVT2 = EVNT.EVNTNUM of
prescription medicine selected at OP12.
XMEDRNDC
XMED.XMEDRNDC = current round.
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
10:57:38 AM Friday, March 06, 2009
Page 47 of 52
BOX OP3
BOX OP3
Page Order # :
240
BOX INSTRUCTIONS
( OPQ1280 )
GO TO OP4_IN - NAVIGATOR ( OPQ1135 ).
ASSIGNMENTS
TECHNICAL NOTES
DESIGN NOTES
10:57:38 AM Friday, March 06, 2009
Page 48 of 52
OP15
OP15
Page Order # :
Design Screen Type:
Yes/No
Fields:
Field 1:
OPMORE
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:
Multi Field display:
Roster/Grid Instructions:
Roster/Grid display:
Report display:
TEXT:
Context Header:
Int. Instr I:
Question Text:
[Since (REFERENCE DATE)/Between (REFERENCE DATE) and
(DATE OF DEATH/DATE OF INSTITUTIONALIZATION)], did
[you/(SP)] have any other visits to the outpatient department at this
or any other hospital for services?
Int. Instr II:
INPUT FIELDS / ROUTING
10:57:39 AM Friday, March 06, 2009
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OP15
OPMORE
Field1:
Cheshire Name:
( OPQ1330 )
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
OP2 - PROVIDER_OP ( OPQ1030 )
English text: YES
No
BOX OP6 - (OPQ1340 )
English text: NO
Attribute
Don't know
Route
BOX OP6 - (OPQ1340 )
Refusal
BOX OP6 - (OPQ1340 )
BACKGROUND VARIABLE ASSIGNMENTS
SOFT EDIT CHECKS
HARD EDIT CHECKS
TECHNICAL NOTES
DESIGN NOTES
End loop 1: OP15 - OPMORE probes for additional Outpatient Department
visits. OP visits can be fore a new provider or a provider already selected
and asked about. If OPMORE=1/Yes, go to OP2 to select the next provider.
10:57:42 AM Friday, March 06, 2009
Page 50 of 52
BOX OP6
BOX OP6
Page Order # :
300
BOX INSTRUCTIONS
( OPQ1340 )
IF FALL ROUND AND ((SP REPORTED AN OUTPATIENT DEPARTMENT
VISIT AT OP4) AND (SP IS ALIVE AND NOT INSTITUTIONALIZED)), GO TO
AC9 - OPDREAS ( ACQ1190 ).
ELSE GO TO BOX OP7 - (OPQ1505 ).
ASSIGNMENTS
TECHNICAL NOTES
98
FallRound
If the remainder of (Current round divided by 3) = 1, then
it is a Fall round.
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.
DESIGN NOTES
Call AC9 if OP event reported.
AC returns at BOX OP7.
10:57:42 AM Friday, March 06, 2009
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BOX OP7
BOX OP7
Page Order # :
380
BOX INSTRUCTIONS
( OPQ1505 )
GO TO NEXT SECTION .
ASSIGNMENTS
TECHNICAL NOTES
DESIGN NOTES
10:57:42 AM Friday, March 06, 2009
Page 52 of 52
| File Type | application/pdf |
| Author | hubbard_r |
| File Modified | 2010-04-06 |
| File Created | 0000-00-00 |