/* SHORT TITLE: Codebook for Patient Quest-Home Health, T1-T6 */
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* W E S T A T C O D E B O O K *
* ----------- --------------- *
* *
* STUDY OF HEALTH CARE COSTS *
* PUBLIC USE MASTER EVENT FILE - HOME HEALTH CARE (G1) *
* 30 JUNE 1994 *
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********************************************************************************
* W E S T A T C O D E B O O K *
* ----------- --------------- *
* *
* STUDY OF HEALTH CARE COSTS *
* PUBLIC USE MASTER EVENT FILE - HOME HEALTH CARE (G1) *
* 30 JUNE 1994 *
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(0)
27 Jun. 1994
Record 01
STUDY OF HEALTH CARE COSTS
PUBLIC USE MASTER EVENT FILE - HOME HEALTH CARE (G1)
30 JUNE 1994
Question Column
Name Number(s)
________ _________
PATID 001-009 PATIENT ID
__________
000000001-
999999999 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
REC 010-011 RECORD NUMBER
_____________
01 = NUMBER
SSUBREC 012-013 SUBRECORD NUMBER
________________
01-99 = SUBRECORD NUMBER
SFORM 014 QUESTIONNAIRE TYPE
__________________
A = TIME 1 ADULT QUESTIONNAIRE
B = TIME 2 ADULT QUESTIONNAIRE
C = TIME 3 ADULT QUESTIONNAIRE
G = TIME 4 ADULT QUESTIONNAIRE
H = TIME 5 ADULT QUESTIONNAIRE
I = TIME 6 ADULT QUESTIONNAIRE
D = TIME 1 PEDIATRIC QUESTIONNAIRE
E = TIME 2 PEDIATRIC QUESTIONNAIRE
F = TIME 3 PEDIATRIC QUESTIONNAIRE
J = TIME 4 PEDIATRIC QUESTIONNAIRE
K = TIME 5 PEDIATRIC QUESTIONNAIRE
L = TIME 6 PEDIATRIC QUESTIONNAIRE
SFPART 015-016 QUESTIONNAIRE QUESTION
______________________
G1 = HOME HEALTH CARE
(1)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
PROVID 017-023 PLEASE TELL ME THE NAME, ADDRESS AND TELEPHONE NUMBER OF THE ORGANIZATION THAT PROVIDED
THIS HELP?
___________
+ = INAPPLICABLE, CODED 11 OR 12 IN SREASON1
0000001-
9999996 = RANDOMLY ASSIGNED PROVIDER ID NUMBER
9999997 = REFUSED
9999998 = DK
9999999 = NOT ASCERTAINED
SRBEGMO 024-025 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SRBEGDY 026-027 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SRBEGYR 028-029 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SRENDMO 030-031 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SRENDDY 032-033 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SRENDYR 034-035 ALWAYS BLANK
____________
+ = ALWAYS BLANK
(2)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
HSPNIT 036-038 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SREASON1 039-040 PROVIDER TYPE
_____________
01 = MD
02 = NURSE
03 = NURSE'S AIDE
04 = SOCIAL WORKER
05 = CASE MANAGER/CASE WORKER
06 = THERAPIST
07 = PAID HELPER/CLEANING/HOUSEKEEPING
08 = MEALS ON WHEELS
09 = VOLUNTEER
10 = BUDDY/ADVOCATE
11 = SOMEONE LIVING WITH RESPONDENT
12 = FRIEND/FAMILY NOT LIVING WITH RESPONDENT
13 = ADVISOR/CLERGY
14 = HOSPICE
15 = LAB TECHNICIAN
16 = TEACHER/TUTOR
17 = CHILD CARE
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
SREASON2 041-042 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SREASON3 043-044 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SREASON4 045-046 ALWAYS BLANK
____________
+ = ALWAYS BLANK
(3)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
CONCD1 047-051 ALWAYS BLANK
____________
+ = ALWAYS BLANK
CONCD2 052-056 ALWAYS BLANK
____________
+ = ALWAYS BLANK
PROCCD1 057-061 ALWAYS BLANK
____________
+ = ALWAYS BLANK
PROCCD2 062-066 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SHH_KOH (067-074) PLEASE LOOK AT THIS CARD. IT SHOWS SOME OF THE DIFFERENT KINDS OF HELP PEOPLE CAN
RECEIVE AT HOME. WHAT TYPE OF HELP DID YOU RECEIVE FROM (PROVIDER)?
CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF
AT LEAST ONE IS CIRCLED, CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED
ITEM(S).
SHH_MED 067 MEDICAL CARE
____________
+ = INAPPLICABLE, CODED 08 IN SREASON1; OR CODED A, B, D OR E IN SFORM
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(4)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
SHH_PER 068 PERSONAL CARE
_____________
+ = INAPPLICABLE, CODED 08 IN SREASON1; OR CODED A, B, D OR E IN SFORM
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
SHH_HOUS 069 LIGHT HOUSEKEEPING
__________________
+ = INAPPLICABLE, CODED 08 IN SREASON1; OR CODED A, B, D OR E IN SFORM
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
SHH_COUN 070 COUNSELING
__________
+ = INAPPLICABLE, CODED 08 IN SREASON1; OR CODED A, B, D OR E IN SFORM
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
SHH_MEAL 071 MEALS DELIVERED
_______________
+ = INAPPLICABLE, CODED 08 IN SREASON1; OR CODED A, B, D OR E IN SFORM
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(5)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
SHH_OTH 072 OTHER SPECIFIED
_______________
+ = INAPPLICABLE, CODED 08 IN SREASON1; OR CODED A, B, D OR E IN SFORM
1 = CIRCLED
* 2 = NOT CIRCLED
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP OSCODE
OSCODE 073-074 OTHER SPECIFIED
_______________
+ = INAPPLICABLE, CODED 08 IN SREASON1; OR CODED A, B, D OR E IN SFORM; OR
CODED 2, 7, 8 OR 9 IN SHH_OTH.
01 = TEACHER/TUTOR
02 = HELP WITH LIFE MANAGEMENT
03 = DELIVERS MEDICAL EQUIPMENT
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
SDRUGCD 075-078 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SRE_EVNT 079-084 YOU TOLD ME THAT YOU HAVE BEEN VISITED AT HOME BY (PROVIDER). THINKING BACK TO (REF.
DATE), HOW MANY DIFFERENT DAYS/MEALS WERE YOU VISITED/GIVEN BY (PROVIDER)?
IF SREASON1 = 08, CODE HERE INDICATES NUMBER OF MEALS PER WEEK RECEIVED
+ = INAPPLICABLE, CODED 11 OR 12 IN SREASON1
000001-000996 = NUMBER DAYS/MEALS
000997 = REFUSED
000998 = DK
000999 = NOT ASCERTAINED
(6)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
HRDYWK 085-087 HOW MANY HOURS PER DAY DID THIS (PROVIDER) USUALLY PROVIDE HELP TO YOU?
IF SREASON1 = 11 OR 12, THIS IS THE NUMBER OF HOURS PER WEEK PERSON HELPED.
+ = INAPPLICABLE, SFORM EQUALS A, B, D OR E AND SREASON1 DOES NOT EQUAL 09,
10, 11 OR 12; OR SFORM EQUALS C, G, H, I, F, J, K OR L AND CODED 08 IN
SREASON1.
000 = LESS THAN 1 HOUR
001-999 = HOURS
SRE_DOL 088-093 HOW MUCH DID YOU OR WILL YOU PAY FOR THIS VISIT?
_________________________________________________
CODER: CODE AMOUNTS IN WHOLE DOLLARS.
+ = INAPPLICABLE, CODED 11 OR 12 IN SREASON1
000000 = NOTHING
000001-999996 = AMOUNT
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
SRE_UC 094 WAS THIS PER VISIT OR THE TOTAL PER VISIT?
___________________________________________
+ = INAPPLICABLE, CODED 11 OR 12 IN SREASON1
1 = PER VISIT
2 = TOTAL
3 = MONTHLY
4 = PERCENTAGE
5 = WEEKLY
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(7)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
SMELSPY 095 DID OR WILL SOMEONE ELSE PAY (AN ADDITIONAL AMOUNT) FOR THIS/THESE VISIT(S)?
_____________________________________________________________________________
+ = INAPPLICABLE, CODED 08, 11 OR 12 IN SREASON1; OR SFORM EQUALS C, G, H, I,
F, J, K OR L AND CODED 08, 09 OR 10 IN SREASON1.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP SRE_CAID - SRE_EOS
WHOELSE (096-103) WHO ELSE IS PAYING FOR THIS/THESE VISIT(S)? (CODE ALL THAT APPLY)
CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF
AT LEAST ONE IS CIRCLED, CODE 1 FOR ALL CIRCLED ITEM (S). CODE 2 FOR ALL UNCIRCLED
ITEM(S).
SRE_CAID 096 MEDICAID
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY; OR CODED 08, 11 OR 12 IN
SREASON1
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
SRE_PUB 097 OTHER PUBLIC ASSISTANCE
_______________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY; OR CODED 08, 11 OR 12 IN
SREASON1
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(8)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
SRE_PRVI 098 PRIVATE INSURANCE
_________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY; OR CODED 08, 11 OR 12 IN
SREASON1
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
SRE_CARE 099 MEDICARE
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY; OR CODED 08, 11 OR 12 IN
SREASON1
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
SRE_RES 100 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SRE_OTHR 101 OTHER SPECIFIED
_______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY; OR CODED 08, 11 OR 12 IN
SREASON1
1 = CIRCLED
* 2 = NOT CIRCLED
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP SRE_EOS
(9)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
SRE_EOS 102-103 OTHER SPECIFIED
_______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN SMELSPY; OR CODED 08, 11 OR 12 IN
SREASON1; OR CODED 2, 7, 8 OR 9 IN SRE_OTHR.
01 = RESEARCH STUDY
03 = FLAT FEE
05 = GAY AIDS TASK FORCE/AIDS NETWORK
14 = FAMILY/FRIEND
29 = COMMUNITY HEALTH PROJECT
46 = PROVIDER
47 = PRIVATE CHARITY
50 = DRUG COMPANY
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
SRE_NOPY 104-105 WHY WAS THERE NO (ADDITIONAL) PAYMENT?
_______________________________________
+ = INAPPLICABLE, CODED 08, 11 OR 12 IN SREASON1; OR CODED 1 IN SMELSPY
01 = FREE FROM PROVIDER/VOLUNTEER SERVICE
02 = PAID IN FULL
03 = CAN'T AFFORD TO PAY
05 = RESEARCH STUDY
06 = GOVT AGENCY/GOVT FUNDING: LOCAL, CITY, COUNTY, STATE, FEDERAL
18 = INCLUDED IN OTHER FEE/FLAT FEE
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
SBPS 106 ALWAYS BLANK
____________
+ = ALWAYS BLANK
SHSTAYFG 107-110 ALWAYS BLANK
____________
+ = ALWAYS BLANK
ICTMFLG 111-116 ALWAYS BLANK
____________
+ = ALWAYS BLANK
(10)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
ANOSTYF1 117-120 ALWAYS BLANK
____________
+ = ALWAYS BLANK
ANOSTYF2 121-124 ALWAYS BLANK
____________
+ = ALWAYS BLANK
AGE 125-126 HOW OLD IS THAT PERSON?
________________________
+ = INAPPLICABLE, CODED A OR D IN SFORM; OR SFORM EQUALS B OR E AND SREASON1
DOES NOT EQUAL 09, 10, 11 OR 12; OR SFORM EQUALS C, G, H, I, F, J, K OR L
AND SREASON1 DOES NOT EQUAL 11 OR 12.
10-90 = AGE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
EMPYD 127 IS THAT PERSON EMPLOYED?
_________________________
+ = INAPPLICABLE, CODED A OR D IN SFORM; OR SREASON1 NOT CODED 11 OR 12
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
HRSEPM 128-130 HOW MANY HOURS PER WEEK DOES HE/SHE WORK AT HIS/HER USUAL JOB?
_______________________________________________________________
+ = INAPPLICABLE, CODED A OR D IN SFORM; OR SREASON1 NOT CODED 11 OR 12
001-072 = HOURS PER WEEK
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(11)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
RELAT 131-132 WHAT IS THIS PERSON'S RELATIONSHIP TO YOU?
___________________________________________
+ = INAPPLICABLE, CODED A OR D IN SFORM; OR SREASON1 NOT CODED 11 OR 12
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
INSURFLG 133 SOURCE OF PAYMENT FOR EVENT DISCREPANT WITH OVERALL INSURANCE COVERAGE (DERIVED)
________________________________________________________________________________
+ = INAPPLICABLE
1 = SOP DISCREPANT WITH PATIENT'S OVERALL INSURANCE COVERAGE FOR THIS SFPART
(12)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
INDEX OF VARIABLES PAGE 001
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== A =====
AGE 125-126 Record 01 011
ANOSTYF1 117-120 Record 01 011
ANOSTYF2 121-124 Record 01 011
===== C =====
CONCD1 047-051 Record 01 004
CONCD2 052-056 Record 01 004
===== E =====
EMPYD 127 Record 01 011
===== H =====
HRDYWK 085-087 Record 01 007
HRSEPM 128-130 Record 01 011
HSPNIT 036-038 Record 01 003
===== I =====
ICTMFLG 111-116 Record 01 010
INSURFLG 133 Record 01 012
===== O =====
OSCODE 073-074 Record 01 006
===== P =====
PATID 001-009 Record 01 001
PROCCD1 057-061 Record 01 004
PROCCD2 062-066 Record 01 004
PROVID 017-023 Record 01 002
===== R =====
REC 010-011 Record 01 001
RELAT 131-132 Record 01 012
===== S =====
SBPS 106 Record 01 010
SDRUGCD 075-078 Record 01 006
SFORM 014 Record 01 001
INDEX OF VARIABLES PAGE 002
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== S =====
SFPART 015-016 Record 01 001
SHH_COUN 070 Record 01 005
SHH_HOUS 069 Record 01 005
SHH_KOH (067-074) Record 01 004
SHH_MEAL 071 Record 01 005
SHH_MED 067 Record 01 004
SHH_OTH 072 Record 01 006
SHH_PER 068 Record 01 005
SHSTAYFG 107-110 Record 01 010
SMELSPY 095 Record 01 008
SRBEGDY 026-027 Record 01 002
SRBEGMO 024-025 Record 01 002
SRBEGYR 028-029 Record 01 002
SRE_CAID 096 Record 01 008
SRE_CARE 099 Record 01 009
SRE_DOL 088-093 Record 01 007
SRE_EOS 102-103 Record 01 010
SRE_EVNT 079-084 Record 01 006
SRE_NOPY 104-105 Record 01 010
SRE_OTHR 101 Record 01 009
SRE_PRVI 098 Record 01 009
SRE_PUB 097 Record 01 008
SRE_RES 100 Record 01 009
SRE_UC 094 Record 01 007
SREASON1 039-040 Record 01 003
SREASON2 041-042 Record 01 003
SREASON3 043-044 Record 01 003
SREASON4 045-046 Record 01 003
SRENDDY 032-033 Record 01 002
SRENDMO 030-031 Record 01 002
SRENDYR 034-035 Record 01 002
SSUBREC 012-013 Record 01 001
===== W =====
WHOELSE (096-103) Record 01 008