MEPS-HC Core Interview

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

Attachment 36 -- HC Disability Days Section

MEPS-HC Core Interview

OMB: 0935-0118

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0935-0118 can be found here:

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MEPS FAMES P12R5/P13R3/P14R1 Disability Days (DD) Section

December 8, 2008

Disability Days (DD) Section

BOX_00

======

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

| CONTEXT HEADER DISPLAY INSTRUCTIONS: |

| DISPLAY PERS.FULLNAME, PRND.BEGREFMM, |

| PRND.BEGREFDD, PRND.BEGREFYY, PRND.ENDREFMM, |

| PRND.ENDREFDD, PRND.ENDREFYY |

| |

| IF PRND DATES ARE MISSING USE RU DATES: |

| RUBEGMM, RUBEGDD, RUENDMM, RUENDDD |

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

BOX_01

======

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

| IF PERSON IS LESS THAN 1 YEAR OF AGE (OR AGE |

| CATEGORY 1), GO TO BOX_03 |

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

| OTHERWISE, CONTINUE WITH DD01 |

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

DD01

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

The next questions ask about time when (PERSON) may have

missed a half day or more from work or school or spent a half

day or more in bed {since (START DATE)/between (START DATE) and

(END DATE)}. In answering these questions, please include any

time when this occurred because of (PERSON)’s physical illness

or injury, or a mental or emotional problem such as stress or

depression.

PRESS ENTER OR SELECT NEXT PAGE TO CONTINUE.

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

| DISPLAY ‘since (START DATE)’ IF NOT ROUND 5. |

| DISPLAY ‘between (START DATE) and (END DATE)’ IF |

| ROUND 5. |

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

| NOTE: THERE IS NO UPPER AGE LIMIT RESTRICTION FOR |

| PERSONS WHO ARE ASKED THE WORK-LOSS DISABILITY |

| DAYS QUESTION. |

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

| IF PERSON IS = OR > 1 YEAR OLD AND < 3 YEARS OLD |

| (OR AGE CATEGORY 2), GO TO DD08 |

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

| IF PERSON IS = OR > 3 YEARS OLD AND < OR = 15 |

| YEARS OLD (OR AGE CATEGORY 3), GO TO DD05 |

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

| IF PERSON IS = OR > 16 YEARS OLD (OR AGE |

| CATEGORIES 4-9), CONTINUE WITH DD02 |

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

DD02

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

{NUMBER OF DAYS IN HOSPITAL: {NUMBER OF DAYS}}

Let's start with work. {Including the time (PERSON) (were/was)

in the hospital, how/How} many days did (PERSON) miss a half

day or more from work {since (START DATE)/between (START DATE)

and (END DATE)}? Please do not include work around the house.

PROBE: Include any time when a half day or more was missed

because of a physical illness or injury, or a mental or

emotional problem.

IF NO DAYS MISSED FROM WORK, CODE ‘995’.

IF PERSON DOES NOT WORK, CODE ‘996’.

[Enter Number of Days] .................

NONE ................................... 995

DOES NOT WORK (OTHER THAN AROUND THE

HOUSE) ................................. 996

REF .................................... -7

DK ..................................... -8

HELP AVAILABLE FOR DEFINITION OF HALF DAY OR MORE.

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

| DISPLAY ‘NUMBER OF DAYS IN HOSPITAL: { }’ IF |

| PERSON HAS AT LEAST ONE HOSPITAL STAY THAT ENDED |

| IN CURRENT ROUND (I.E., DISCHARGE DATE NOT |

| CODED ‘95’ (STILL IN HOSPITAL)). OTHERWISE, USE A |

| NULL DISPLAY. |

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

| FOR ‘NUMBER OF DAYS’, DISPLAY TOTAL NUMBER OF DAYS|

| PERSON WAS IN HOSPITAL FOR ALL HOSPITAL STAYS THAT|

| ENDED IN CURRENT ROUND (I.E., DISCHARGE DATE NOT |

| CODED ‘95’ (STILL IN HOSPITAL)). OTHERWISE, USE A |

| NULL DISPLAY. |

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

| DISPLAY ‘Including the time..., how’ IF PERSON HAS|

| AT LEAST ONE HOSPITAL STAY THAT ENDED IN CURRENT |

| ROUND (I.E., DISCHARGE DATE NOT CODED ‘95’ (STILL |

| IN HOSPITAL)). |

| OTHERWISE, DISPLAY ‘How’. |

| DISPLAY ‘since (START DATE)’ IF NOT ROUND 5. |

| DISPLAY ‘between (START DATE) and (END DATE)’ IF |

| ROUND 5. |

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

| IF ‘0’ ENTERED, DISPLAY THE FOLLOWING ERROR |

| MESSAGE: ‘IF NO WORK DAYS MISSED, ENTER ‘995’ TO |

| RECORD THIS INFORMATION. |

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

| IF NUMBER ENTERED > NUMBER OF DAYS IN REFERENCE |

| PERIOD, DISPLAY THE FOLLOWING ERROR MESSAGE: |

| ‘NUMBER OF DAYS MUST BE EQUAL TO OR LESS THAN |

| NUMBER IN REFERENCE PERIOD.’ |

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

| IF CODED '995' (NO DAYS MISSED FROM WORK), '996' |

| (DOES NOT WORK), '-7' (REFUSED), OR '-8' (DON'T |

| KNOW) AND PERSON IS 16 THROUGH 22 YEARS OF AGE |

| INCLUSIVE (OR AGE CATEGORY 4), GO TO DD05 |

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

| IF CODED '995' (NO DAYS MISSED FROM WORK), '996' |

| (DOES NOT WORK), '-7' (REFUSED), OR '-8' (DON'T |

| KNOW) AND PERSON IS 23 YEARS OF AGE OR OLDER (OR |

| AGE CATEGORIES 5-9), GO TO DD08 |

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

| OTHERWISE, CONTINUE WITH BOX_01A |

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

| HARD CHECK: |

| RANGE CHECK: 1 THROUGH NUMBER OF DAYS IN REFERENCE|

| PERIOD OR 996 FOR THIS PERSON. |

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

BOX_01A

=======

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

| IF ROUND 3, CONTINUE WITH DD02A |

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

| OTHERWISE (I.E., IF NOT ROUND 3), GO TO DD03 |

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

DD02A

=====

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

NUMBER OF DAYS MISSED WORK: {NUMBER OF DAYS}

Of those days, how many were in {YEAR}?

[Enter Number of Days] ................. {DD03}

REF ................................... -7 {DD03}

DK .................................... -8 {DD03}

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

| FOR ‘NUMBER OF DAYS,’ DISPLAY THE NUMBER ENTERED |

| AT DD02 |

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

| (FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES |

| AUTOMATICALLY): ‘YEAR’ IN QUESTION TEXT IS FIRST |

| CALENDAR YEAR OF PANEL. |

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

| HARD CHECK: |

| DAYS IN {YEAR} AT DD02A MUST BE < OR = DAYS MISSED|

| FROM WORK AT DD02. |

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

DD03

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

What are the health problems that caused (PERSON) to miss work

on those days?

PROBE: Any other health problems?

IF CONDITION IS ALREADY LISTED, SELECT ENTRY ON ROSTER.

[1. Medical Condition]

[2. Medical Condition]

[3. Medical Condition]

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

| FLAG ALL CONDITIONS SELECTED OR ADDED AS BEING |

| ASSOCIATED WITH MISSED WORK DAYS IN THIS ROUND. |

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

| DISPLAY ‘ADD CONDITION’ AS AN OPTION ON THIS |

| SCREEN. |

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

| GO TO DD04 |

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

| ROSTER DETAILS: |

| Title: PERS_COND_1 |

| |

| COL #1 HEADER: MEDICAL CONDITION |

| INSTRUCTIONS: DISPLAY NAME OF MEDICAL CONDITION |

| (COND.CONDNAM) |

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

| ROSTER DEFINITION: |

| DISPLAY THE PERSON-MEDICAL-CONDITIONS-ROSTER FOR |

| THE SELECTION AND ADDITION OF ONE OR MANY MEDICAL |

| CONDITION(S) ASSOCIATED WITH THIS EVENT. |

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

| ROSTER BEHAVIOR: |

| 1. MULTIPLE SELECT ALLOWED. |

| |

| 2. MULTIPLE ADD ALLOWED. |

| |

| 3. LIMITED DELETE ALLOWED. INTERVIEWER MAY DELETE |

| A CONDITION ADDED ON THIS SCREEN AS LONG AS THE |

| INTERVIEWER HAS NOT YET LEFT THE SCREEN. IF THE |

| INTERVIEWER ATTEMPTS TO DELETE A CONDITION WHEN |

| DELETE IS NOT ALLOWED, DISPLAY THE FOLLOWING |

| MESSAGE: “DELETE ALLOWED ONLY WHEN CONDITION IS |

| FIRST ENTERED.” |

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

| ROSTER FILTER: |

| DISPLAY ALL CONDITIONS ON PERSON’S ROSTER; NO |

| FILTER. |

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

DD04

====

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

NUMBER OF DAYS MISSED WORK: {NUMBER OF DAYS}

Of those days, how many did (PERSON) stay in bed for a half

day or more?

[Enter Number of Days] .................

REF ................................... -7

DK .................................... -8

HELP AVAILABLE FOR DEFINITION OF STAY IN BED.

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

| FOR ‘NUMBER OF DAYS’, DISPLAY THE NUMBER ENTERED |

| AT DD02. |

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

| IF DD02A OR DD04 EQUALS 0, DON'T KNOW OR REFUSED |

| AND PERSON IS 16 THROUGH 22 YEARS OF AGE INCLUSIVE|

| (OR AGE CATEGORY 4), GO TO DD05 |

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

| IF DD02A OR DD04 EQUALS 0, DON'T KNOW OR REFUSED |

| AND PERSON IS 23 YEARS OF AGE OR OLDER (OR AGE |

| CATEGORIES 5-9), GO TO DD08 |

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

| OTHERWISE, CONTINUE WITH BOX_01B |

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

| HARD CHECK: |

| DAYS IN BED AT DD04 MUST BE < OR = DAYS MISSED |

| FROM WORK AT DD02. |

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

BOX_01B

=======

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

| IF ROUND 3, CONTINUE WITH DD04A |

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

| IF NOT ROUND 3 AND PERSON IS 16 THROUGH 22 YEARS |

| OF AGE INCLUSIVE (OR AGE CATEGORY 4), GO TO DD05 |

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

| IF NOT ROUND 3 AND PERSON IS 23 YEARS OF AGE OR |

| OLDER (OR AGE CATEGORIES 5-9), GO TO DD08 |

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

DD04A

=====

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

NUMBER OF DAYS IN BED: {NUMBER OF DAYS}

Of those days, how many were in {YEAR}?

[Enter Number of Days] .................

REF ................................... -7

DK .................................... -8

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

| FOR ‘NUMBER OF DAYS,’ DISPLAY THE NUMBER ENTERED |

| AT DD04 |

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

| (FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES |

| AUTOMATICALLY): ‘YEAR’ IN QUESTION TEXT IS FIRST |

| CALENDAR YEAR OF PANEL. |

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

| IF PERSON IS 16 THROUGH 22 YEARS OF AGE INCLUSIVE |

| (OR AGE CATEGORY 4), CONTINUE WITH DD05 |

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

| IF PERSON IS 23 YEARS OF AGE OR OLDER (OR AGE |

| CATEGORIES 5-9), GO TO DD08 |

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

| HARD CHECK: |

| DAYS IN BED IN {YEAR} AT DD04A MUST BE < OR = DAYS|

| IN BED AT DD04. |

| |

| DAYS IN BED IN {YEAR} AT DD04A MUST BE < OR = DAYS|

| MISSED FROM WORK IN {YEAR} AT DD02A. |

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

DD05

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

{NUMBER OF DAYS IN HOSPITAL: {NUMBER OF DAYS}}

Let's talk about school (and day care). {Including the time

(PERSON) (were/was) in the hospital, how/How} many days did

(PERSON) miss a half day or more of school (or day care) {since

(START DATE)/between (START DATE) and (END DATE)}?

PROBE: Include any time when a half day or more of school (or

day care) was missed because of a physical illness or injury, or

a mental or emotional problem.

IF NO DAYS MISSED FROM SCHOOL, CODE ‘995’.

IF PERSON DOES NOT ATTEND SCHOOL, CODE ‘996’.

[Enter Number of Days] .................

NONE ................................... 995 {DD08}

DOES NOT ATTEND SCHOOL ................. 996 {DD08}

REF .................................... -7 {DD08}

DK ..................................... -8 {DD08}

HELP AVAILABLE FOR DEFINITION OF HALF DAY OR MORE.

[Code One]

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

| DISPLAY ‘NUMBER OF DAYS IN HOSPITAL: { }’ IF |

| PERSON HAS AT LEAST ONE HOSPITAL STAY THAT ENDED |

| IN CURRENT ROUND (I.E., DISCHARGE DATE NOT |

| CODED ‘95’ (STILL IN HOSPITAL)). OTHERWISE, USE A |

| NULL DISPLAY. |

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

| FOR ‘NUMBER OF DAYS’, DISPLAY TOTAL NUMBER OF DAYS|

| PERSON WAS IN HOSPITAL FOR ALL HOSPITAL STAYS THAT|

| ENDED IN CURRENT ROUND (I.E., DISCHARGE DATE NOT |

| CODED ‘95’ (STILL IN HOSPITAL)). OTHERWISE, USE A |

| NULL DISPLAY. |

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

| DISPLAY ‘Including the time..., how’ IF PERSON HAS|

| AT LEAST ONE HOSPITAL STAY THAT ENDED IN CURRENT |

| ROUND (I.E., DISCHARGE DATE NOT CODED ‘95’ (STILL |

| IN HOSPITAL)). |

| OTHERWISE, DISPLAY ‘How’. |

| DISPLAY ‘since (START DATE)’ IF NOT ROUND 5. |

| DISPLAY ‘between (START DATE) and (END DATE)’ IF |

| ROUND 5. |

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

| IF ‘0’ ENTERED, DISPLAY THE FOLLOWING ERROR |

| MESSAGE: ‘IF NO SCHOOL DAYS MISSED, ENTER ‘995’ |

| TO RECORD THIS INFORMATION.’ |

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

| IF NUMBER ENTERED > NUMBER OF DAYS IN REFERENCE |

| PERIOD, DISPLAY THE FOLLOWING ERROR MESSAGE: |

| ‘NUMBER OF DAYS MUST BE EQUAL TO OR LESS THAN |

| NUMBER OF DAYS IN REFERENCE PERIOD.’ |

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

| IF ‘995’ OR ‘996’ ENTERED FOR NUMBER OF DAYS, GO |

| TO DD08. |

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

| IF NUMBER OF DAYS ENTERED (AND NOT ‘995’, ‘996’, |

| DK, OR RF), CONTINUE WITH BOX_01C. |

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

| HARD CHECK: |

| RANGE CHECK: 1 THROUGH NUMBER OF DAYS IN REFERENCE|

| PERIOD FOR THIS PERSON. |

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

BOX_01C

=======

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

| IF ROUND 3, CONTINUE WITH DD05A |

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

| OTHERWISE (I.E., IF NOT ROUND 3), GO TO DD06 |

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

DD05A

=====

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

NUMBER OF DAYS MISSED SCHOOL: {NUMBER OF DAYS}

Of those days, how many were in {YEAR}?

[Enter Number of Days] ................. {DD06}

REF ................................... -7 {DD06}

DK .................................... -8 {DD06}

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

| FOR ‘NUMBER OF DAYS,’ DISPLAY THE NUMBER ENTERED |

| AT DD05. |

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

| (FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES |

| AUTOMATICALLY): ‘YEAR’ IN QUESTION TEXT IS FIRST |

| CALENDAR YEAR OF PANEL. |

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

| HARD CHECK: |

| DAYS MISSED FROM SCHOOL IN {YEAR} AT DD05A MUST BE|

| < OR = DAYS MISSED FROM SCHOOL AT DD05. |

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

DD06

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

What are the health problems that caused (PERSON) to miss

school on those days?

PROBE: Any other health problems?

IF CONDITION IS ALREADY LISTED, SELECT ENTRY ON ROSTER.

[1. Medical Condition]

[2. Medical Condition]

[3. Medical Condition]

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

| FLAG ALL CONDITIONS SELECTED OR ADDED AS BEING |

| ASSOCIATED WITH MISSED SCHOOL DAYS IN THIS ROUND. |

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

| DISPLAY ‘ADD CONDITION’ AS AN OPTION ON THIS |

| SCREEN. |

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

| GO TO DD07 |

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

| ROSTER DETAILS: |

| Title: PERS_COND_1 |

| |

| COL #1 HEADER: MEDICAL CONDITION |

| INSTRUCTIONS: DISPLAY NAME OF MEDICAL CONDITION |

| (COND.CONDNAM) |

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

| ROSTER DEFINITION: |

| DISPLAY THE PERSON-MEDICAL-CONDITIONS-ROSTER FOR |

| THE SELECTION AND ADDITION OF ONE OR MANY MEDICAL |

| CONDITION(S) ASSOCIATED WITH THIS EVENT. |

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

| ROSTER BEHAVIOR: |

| 1. MULTIPLE SELECT ALLOWED. |

| |

| 2. MULTIPLE ADD ALLOWED. |

| |

| 3. LIMITED DELETE ALLOWED. INTERVIEWER MAY DELETE |

| A CONDITION ADDED ON THIS SCREEN AS LONG AS THE |

| INTERVIEWER HAS NOT YET LEFT THE SCREEN. IF THE |

| INTERVIEWER ATTEMPTS TO DELETE A CONDITION WHEN |

| DELETE IS NOT ALLOWED, DISPLAY THE FOLLOWING |

| MESSAGE: “DELETE ALLOWED ONLY WHEN CONDITION IS |

| FIRST ENTERED.” |

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

| ROSTER FILTER: |

| DISPLAY ALL CONDITIONS ON PERSON’S ROSTER; NO |

| FILTER. |

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

DD07

====

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

NUMBER OF DAYS MISSED SCHOOL: {NUMBER OF DAYS}

Of those days, how many did (PERSON) stay in bed a half day or

more?

[Enter Number of Days] .................

REF ................................... -7 {DD08}

DK .................................... -8 {DD08}

HELP AVAILABLE FOR DEFINITION OF STAY IN BED.

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

| FOR ‘NUMBER OF DAYS’, DISPLAY NUMBER RECORDED IN |

| DD05. |

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

| IF DD05A OR DD07 EQUALS 0, DON'T KNOW, OR REFUSED,|

| GO TO DD08 |

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

| OTHERWISE, CONTINUE WITH BOX_01D |

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

| HARD CHECK: |

| DAYS IN BED AT DD07 MUST BE < OR = DAYS MISSED |

| FROM SCHOOL AT DD05. |

| |

| TOTAL BED DAYS (SUM OF ENTRY AT DD04 PLUS ENTRY AT|

| DD07) MUST BE < OR = NUMBER OF DAYS IN REFERENCE |

| PERIOD FOR PERSON. |

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

BOX_01D

=======

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

| IF ROUND 3, CONTINUE WITH DD07A |

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

| OTHERWISE (I.E., IF NOT ROUND 3), GO TO DD08 |

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

DD07A

=====

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

NUMBER OF DAYS IN BED: {NUMBER OF DAYS}

Of those days, how many were in {YEAR}?

[Enter Number of Days] .................

REF ................................... -7

DK .................................... -8

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

| FOR ‘NUMBER OF DAYS,’ DISPLAY THE NUMBER ENTERED |

| AT DD07. |

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

| (FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES |

| AUTOMATICALLY): ‘YEAR’ IN QUESTION TEXT IS FIRST |

| CALENDAR YEAR OF PANEL. |

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

| HARD CHECK: |

| DAYS IN BED IN {YEAR} AT DD07A MUST BE < OR = DAYS|

| IN BED AT DD07. |

| |

| DAYS IN BED IN {YEAR} AT DD07A MUST BE < OR = DAYS|

| MISSED SCHOOL IN {YEAR} AT DD05A. |

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

DD08

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

{NUMBER OF DAYS IN HOSPITAL: {NUMBER OF DAYS}}

{Besides the days in bed you just told me about, how/How} many

{additional} days did (PERSON) spend a half day or more in bed

{since (START DATE)/between (START DATE) and (END DATE)} because

of a physical illness or injury, or mental or emotional problem?

{Please include the time (PERSON) (were/was) in the hospital.}

IF NO {ADDITIONAL} BED DAYS, CODE ‘995’.

[Enter Number of Days] .................

NONE ................................... 995 {BOX_02}

REF .................................... -7 {BOX_02}

DK ..................................... -8 {BOX_02}

HELP AVAILABLE FOR DEFINITION OF HALF DAY OR MORE AND STAY IN BED.

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

| DISPLAY ‘NUMBER OF DAYS IN HOSPITAL: { }’ IF |

| PERSON HAS AT LEAST ONE HOSPITAL STAY THAT ENDED |

| IN CURRENT ROUND (I.E., DISCHARGE DATE NOT |

| CODED ‘95’ (STILL IN HOSPITAL)). OTHERWISE, USE A |

| NULL DISPLAY. |

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

| FOR ‘NUMBER OF DAYS’, DISPLAY TOTAL NUMBER OF DAYS|

| PERSON WAS IN HOSPITAL FOR ALL HOSPITAL STAYS THAT|

| ENDED IN CURRENT ROUND (I.E., DISCHARGE DATE NOT |

| CODED ‘95’ (STILL IN HOSPITAL)). OTHERWISE, USE A |

| NULL DISPLAY. |

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

| DISPLAY ’Besides the days...how’, ‘additional’, |

| IN THE QUESTION TEXT, AND ‘ADDITIONAL’ IN THE |

| LABEL OF THE RADIO BUTTON IF ANY BED DAYS RECORDED|

| FOR THIS PERSON IN EITHER DD04 OR DD07. IF NO BED|

| DAYS RECORDED AT DD04 AND DD07, DISPLAY, ‘How’. |

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

| DISPLAY ‘since (START DATE)’ IF NOT ROUND 5. |

| DISPLAY ‘between (START DATE) and (END DATE)’ IF |

| ROUND 5. |

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

| DISPLAY ‘Please include...’ IF PERSON HAS AT |

| LEAST ONE HOSPITAL STAY THAT ENDED IN CURRENT |

| ROUND (I.E., DISCHARGE DATE NOT CODED ‘95’ (STILL |

| IN HOSPITAL)). |

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

| IF ‘0’ ENTERED, DISPLAY THE FOLLOWING ERROR |

| MESSAGE: ‘IF NO ADDITIONAL BED DAYS, RECORD ‘995’|

| IN NUMBER OF DAYS.’ |

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

| IF’995’ ENTERED FOR NUMBER OF DAYS, GO TO BOX_02 |

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

| IF NUMBER OF DAYS ENTERED (NOT ‘995’, RF, OR DK), |

| CONTINUE WITH BOX_01E |

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

| HARD CHECK: |

| RANGE CHECK: 1 THROUGH NUMBER OF DAYS IN REFERENCE|

| PERIOD FOR THIS PERSON. |

| |

| EDIT: TOTAL BED DAYS (SUM OF ENTRY AT DD04 PLUS |

| ENTRY AT DD07 PLUS ENTRY AT DD08) MUST BE LESS |

| THAN OR EQUAL TO NUMBER OF DAYS IN REFERENCE |

| PERIOD FOR PERSON. |

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

BOX_01E

=======

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

| IF ROUND 3, CONTINUE WITH DD08A |

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

| OTHERWISE (I.E., IF NOT ROUND 3), GO TO DD09 |

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

DD08A

=====

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

NUMBER OF {ADDITIONAL} DAYS IN BED: {NUMBER OF DAYS}

Of those days, how many were in {YEAR}?

[Enter Number of Days] ................. {DD09}

REF ................................... -7 {DD09}

DK .................................... -8 {DD09}

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

| DISPLAY ‘ADDITIONAL’ IF ANY BED DAYS RECORDED FOR |

| THIS PERSON IN EITHER DD04 OR DD07. OTHERWISE, |

| USE A NULL DISPLAY. |

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

| FOR ‘NUMBER OF DAYS,’ DISPLAY THE NUMBER ENTERED |

| AT DD08. |

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

| (FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES |

| AUTOMATICALLY): ‘YEAR’ IN QUESTION TEXT IS FIRST |

| CALENDAR YEAR OF PANEL. |

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

| HARD CHECK: |

| DAYS IN {YEAR} AT DD08A MUST BE < OR = ADDITIONAL |

| DAYS IN BED AT DD08. |

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

DD09

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

What are the health problems that caused (PERSON) to spend a half

day or more in bed on those days?

PROBE: Any other health problems?

IF CONDITION IS ALREADY LISTED, SELECT ENTRY ON ROSTER.

[1. Medical Condition]

[2. Medical Condition]

[3. Medical Condition]

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

| FLAG ALL CONDITIONS SELECTED OR ADDED AS BEING |

| ASSOCIATED WITH BED DAYS IN THIS ROUND. |

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

| DISPLAY ‘ADD CONDITION’ AS AN OPTION ON THIS |

| SCREEN. |

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

| GO TO BOX_02 |

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

| ROSTER DETAILS: |

| Title: PERS_COND_1 |

| |

| COL #1 HEADER: MEDICAL CONDITION |

| INSTRUCTIONS: DISPLAY NAME OF MEDICAL CONDITION |

| (COND.CONDNAM) |

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

| ROSTER DEFINITION: |

| DISPLAY THE PERSON-MEDICAL-CONDITIONS-ROSTER FOR |

| THE SELECTION AND ADDITION OF ONE OR MANY MEDICAL |

| CONDITION(S) ASSOCIATED WITH THIS EVENT. |

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

| ROSTER BEHAVIOR: |

| 1. MULTIPLE SELECT ALLOWED. |

| |

| 2. MULTIPLE ADD ALLOWED. |

| |

| 3. LIMITED DELETE ALLOWED. INTERVIEWER MAY DELETE |

| A CONDITION ADDED ON THIS SCREEN AS LONG AS THE |

| INTERVIEW HAS NOT YET LEFT THE SCREEN. IS |

| IF THE INTERVIEWER ATTEMPTS TO DELETE A CONDITION |

| WHEN DELETE IS NOT ALLOWED, DISPLAY THE FOLLOWING |

| MESSAGE: “DELETE ALLOWED ONLY WHEN CONDITION IS |

| FIRST ENTERED.” |

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

| ROSTER FILTER: |

| DISPLAY ALL CONDITIONS ON PERSON’S ROSTER; NO |

| FILTER. |

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

BOX_02

======

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

| CHECK AGE AND WORK STATUS: |

| IF LESS THAN 16 YEARS OF AGE (OR AGE CATEGORIES |

| 1-3), GO TO BOX_03 |

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

| IF 16 YEARS OF AGE OR OLDER (OR AGE CATEGORIES |

| 4-9) AND DD02 IS NOT CODED '996' (DOES NOT WORK |

| OTHER THAN AROUND THE HOUSE), CONTINUE WITH DD10 |

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

| IF 16 YEARS OF AGE OR OLDER (OR AGE CATEGORIES |

| 4-9) AND DD02 IS CODED '996' (DOES NOT WORK |

| OTHER THAN AROUND THE HOUSE), GO TO BOX_03 |

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

DD10

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

{Besides the {NUMBER OF MISSED WORK DAYS} days (PERSON) missed

a half day or more from work because of (PERSON)'s own illness

or injury, did/Did} (PERSON) miss more than a half day from

work {between (START DATE) and (END DATE)} because of someone

else's illness, injury, or health care needs, for example, to

take care of a sick child or a relative?

YES .................................... 1 {DD11}

NO/DO NOT WORK ......................... 2 {BOX_03}

REF ................................... -7 {BOX_03}

DK .................................... -8 {BOX_03}

[Code One]

HELP AVAILABLE FOR DEFINITION OF HALF DAY OR MORE.

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

| DISPLAY ‘Besides the ..., did’ IF ANY MISSED WORK |

| DAYS RECORDED FOR THIS PERSON IN DD02. DISPLAY |

| ‘Did’ IF NO MISSED WORK DAYS RECORDED FOR THIS |

| PERSON IN DD02. |

| |

| DISPLAY NUMBER RECORDED IN DD02 FOR ‘NUMBER OF |

| MISSED WORK DAYS’ IF DD02 DOES NOT = ‘-7’ |

| (REFUSED) OR ‘-8’ (DON’T KNOW). IF DD02 = ‘-7’ |

| (REFUSED) OR ‘-8’ (DON’T KNOW), USE A NULL |

| DISPLAY. |

| |

| DISPLAY ‘between (START DATE) and (END DATE)’ IF |

| ROUND 5. OTHERWISE, USE A NULL DISPLAY. |

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

DD11

====

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

How many days did (PERSON) miss a half day or more from work

because of someone else's illness, injury, or health care needs?

[Enter Number of Days] ................. {BOX_02A}

REF ................................... -7 {BOX_03}

DK .................................... -8 {BOX_03}

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

| IF ‘0’ ENTERED, DISPLAY THE FOLLOWING ERROR |

| MESSAGE: ‘IF NO WORK DAYS MISSED, BACK UP AND |

| CORRECT PREVIOUS ANSWER.’ |

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

| IF NUMBER ENTERED > NUMBER OF DAYS IN REFERENCE |

| PERIOD, DISPLAY THE FOLLOWING ERROR MESSAGE: |

| ‘NUMBER OF DAYS MUST BE EQUAL TO OR LESS THAN |

| NUMBER IN REFERENCE PERIOD.’ |

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

| HARD CHECK: |

| DAYS ENTERED AT DD11 MUST BE < OR = NUMBER OF DAYS|

| IN REFERENCE PERIOD FOR PERSON. |

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

BOX_02A

=======

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

| IF ROUND 3, CONTINUE WITH DD11A |

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

| OTHERWISE (I.E., IF NOT ROUND 3), GO TO BOX_03 |

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

DD11A

=====

{PERSON’S FIRST MIDDLE AND LAST NAME} {STR-DT}

{END-DT}

NUMBER OF DAYS MISSED WORK DUE TO SOMEONE ELSE’S HEALTH:

{NUMBER OF DAYS}

Of those days, how many were in {YEAR}?

[Enter Number of Days] ................. {BOX_03}

REF ................................... -7 {BOX_03}

DK .................................... -8 {BOX_03}

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

| FOR ‘NUMBER OF DAYS,’ DISPLAY THE NUMBER ENTERED |

| AT DD11. |

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

| (FOR SPECIFICATIONS PURPOSES ONLY; CAPI HANDLES |

| AUTOMATICALLY): ‘YEAR’ IN QUESTION TEXT IS FIRST |

| CALENDAR YEAR OF PANEL. |

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

| HARD CHECK: |

| DAYS IN {YEAR} AT DD11A MUST BE < OR = DAYS MISSED|

| WORK DUE TO SOMEONE ELSE’S HEALTH AT DD11. |

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

BOX_03

======

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

| GO TO NEXT QUESTIONNAIRE SECTION |

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

22-23

File Type	application/msword
File Title	MEPS Disability Days - P12R5/P13R3/P14R1
Subject	DD Section Item Specifications
Author	Agency for Healthcare Research and Quality
Last Modified By	wcarroll
File Modified	2009-07-09
File Created	2009-07-09