/* SHORT TITLE: Codebook for MASTER EVENT FILE - FINANCIAL ASSISTANCE (H6) */ ******************************************************************************** * W E S T A T C O D E B O O K * * ----------- --------------- * * * * STUDY OF HEALTH CARE COSTS * * PUBLIC USE MASTER EVENT FILE - FINANCIAL ASSISTANCE (H6) * * 30 JUNE 1994 * ******************************************************************************** ******************************************************************************** * W E S T A T C O D E B O O K * * ----------- --------------- * * * * STUDY OF HEALTH CARE COSTS * * PUBLIC USE MASTER EVENT FILE - FINANCIAL ASSISTANCE (H6) * * 30 JUNE 1994 * ******************************************************************************** (0) 27 Jun. 1994 Record 01 STUDY OF HEALTH CARE COSTS PUBLIC USE MASTER EVENT FILE - FINANCIAL ASSISTANCE (H6) 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 ______________________ H6 = FINANCIAL ASSISTANCE (1) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ PROVID 017-023 YOU SAID YOU RECEIVED HELP WITH (FINANCIAL ASSISTANCE). PLEASE TELL ME THE NAME, ADDRESS AND TELEPHONE NUMBER OF THE ORGANIZATION THAT PROVIDED THAT HELP. __________________________________________________________________ 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 HSPNIT 036-038 ALWAYS BLANK ____________ + = ALWAYS BLANK (2) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ REASONS (039-046) SINCE (REF. DATE), WHAT KIND OF HELP DID YOU RECEIVE? DID YOU RECEIVE...? (CODE ALL THAT APPLY.) CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED, CODE 9 OR EACH ITEM. IF AT LEAST ONE ITEM IS CIRCLED, CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S). SREASON1 039-040 CASH ____ + = INAPPLICABLE, CODED A, B, D OR E IN SFORM 01 = CIRCLED 02 = NOT CIRCLED 07 = REFUSED 08 = DK 09 = NOT ASCERTAINED SREASON2 041-042 HELP APPLYING FOR FINANCIAL BENEFITS ____________________________________ + = INAPPLICABLE, CODED A, B, D OR E IN SFORM 01 = CIRCLED 02 = NOT CIRCLED 07 = REFUSED 08 = DK 09 = NOT ASCERTAINED SREASON3 043-044 OTHER (SPECIFY) _______________ + = INAPPLICABLE, CODED A, B, D OR E IN SFORM 01 = CIRCLED * 02 = NOT CIRCLED * 07 = REFUSED * 08 = DK * 09 = NOT ASCERTAINED * SKIP SREASON4 (3) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SREASON4 045-046 OTHER SPECIFIED CODE ____________________ + = INAPPLICABLE, CODED A, B, D OR E IN SFORM; OR CODED 02, 07, 08 OR 09 IN SREASON3 01 = RENT ASSISTANCE 02 = UTILITIES & OR RENT 03 = FOOD CERTIFICATES/COUPONS/STAMPS 04 = WELFARE/GENERAL ASSISTANCE 05 = PAY HEALTH INSURANCE 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED 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_MED 067 ALWAYS BLANK ____________ + = ALWAYS BLANK SHH_PER 068 ALWAYS BLANK ____________ + = ALWAYS BLANK (4) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SHH_HOUS 069 ALWAYS BLANK ____________ + = ALWAYS BLANK SHH_COUN 070 ALWAYS BLANK ____________ + = ALWAYS BLANK SHH_MEAL 071 ALWAYS BLANK ____________ + = ALWAYS BLANK SHH_OTH 072 ALWAYS BLANK ____________ + = ALWAYS BLANK OSCODE 073-074 ALWAYS BLANK ____________ + = ALWAYS BLANK SDRUGCD 075-078 ALWAYS BLANK ____________ + = ALWAYS BLANK SRE_EVNT 079-084 HOW MUCH MONEY DID YOU RECEIVE? ________________________________ + = INAPPLICABLE, CODED A, B, D OR E IN SFORM; OR CODED 02, 07, 08 OR 09 IN SREASON1. 000001-999996 = AMOUNT OF MONEY 999997 = REFUSED 999998 = DK 999999 = NOT ASCERTAINED HRDYWK 085-087 ALWAYS BLANK ____________ + = ALWAYS BLANK (5) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SRE_DOL 088-093 HOW MUCH DID YOU OR WILL YOU PAY FOR THIS SERVICE? ___________________________________________________ + = INAPPLICABLE, CODED C, F, G, H, I, J, K OR L IN SFORM. 000000 = NOTHING 000001-999996 = AMOUNT 999997 = REFUSED 999998 = DK 999999 = NOT ASCERTAINED SRE_UC 094 ALWAYS BLANK ____________ + = ALWAYS BLANK SMELSPY 095 DID OR WILL SOMEONE ELSE PAY (AN ADDITIONAL AMOUNT) FOR THIS SERVICE? ______________________________________________________________________ + = INAPPLICABLE, CODED C, F, G, H, I, J, K OR L IN SFORM 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) SERVICES? (CODE ALL THAT APPLY) CODER: AT LEAST ONE ITEM MUST BE CIRCLED. IF NONE ARE CIRCLED CODE 9 FOR EACH ITEM. IF ONE IS CIRCLED CODE 1 FOR ALL CIRCLED ITEM(S). CODE 2 FOR ALL UNCIRCLED ITEM(S). SRE_CAID 096 MEDICAID ________ + = INAPPLICABLE, CODED C, F, G, H, I, J, K OR L IN SFORM; OR CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED (6) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SRE_PUB 097 OTHER PUBLIC ASSISTANCE _______________________ + = INAPPLICABLE, CODED C, F, G, H, I, J, K OR L IN SFORM; OR CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED SRE_PRVI 098 PRIVATE INSURANCE _________________ + = INAPPLICABLE, CODED C, F, G, H, I, J, K OR L IN SFORM; OR CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED SRE_CARE 099 MEDICARE ________ + = INAPPLICABLE, CODED C, F, G, H, I, J, K OR L IN SFORM; OR CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED 2 = NOT CIRCLED 7 = REFUSED 8 = DK 9 = NOT ASCERTAINED SRE_RES 100 ALWAYS BLANK ____________ + = ALWAYS BLANK (7) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SRE_OTHR 101 OTHER SPECIFIED _______________ + = INAPPLICABLE, CODED C, F, G, H, I, J, K OR L IN SFORM; OR CODED 2, 7, 8 OR 9 IN SMELSPY 1 = CIRCLED * 2 = NOT CIRCLED * 7 = REFUSED * 8 = DK * 9 = NOT ASCERTAINED * SKIP SRE_EOS SRE_EOS 102-103 OTHER SPECIFIED _______________ + = INAPPLICABLE, CODED C, F, G, H, I, J, K OR L IN SFORM; OR CODED 2, 7, 8 OR 9 IN SMELSPY; 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 MEMBER/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 C, F, G, H, I, J, K OR L IN SFORM; OR CODED 1 IN SMELSPY 01 = FREE FROM PROVIDER 02 = PAID IN FULL 03 = CAN'T AFFORD TO PAY 05 = RESEARCH STUDY 06 = GOVT AGENCY/GOVT FUNDED: LOCAL, CITY, COUNTY, STATE, FEDERAL 18 = INCLUDED IN OTHER FEE/FLAT FEE 91 = OTHER SPECIFIED 97 = REFUSED 98 = DK 99 = NOT ASCERTAINED (8) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ SBPS 106 ALWAYS BLANK ____________ + = ALWAYS BLANK SHSTAYFG 107-110 ALWAYS BLANK ____________ + = ALWAYS BLANK ICTMFLG 111-116 ALWAYS BLANK ____________ + = ALWAYS BLANK ANOSTYF1 117-120 ALWAYS BLANK ____________ + = ALWAYS BLANK ANOSTYF2 121-124 ALWAYS BLANK ____________ + = ALWAYS BLANK AGE 125-126 ALWAYS BLANK ____________ + = ALWAYS BLANK EMPYD 127 ALWAYS BLANK ____________ + = ALWAYS BLANK HRSEPM 128-130 ALWAYS BLANK ____________ + = ALWAYS BLANK (9) 27 Jun. 1994 Record 01 Question Column Name Number(s) ________ _________ RELAT 131-132 ALWAYS BLANK ____________ + = ALWAYS BLANK INSURFLG 133 ALWAYS BLANK ____________ + = ALWAYS BLANK (10) 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 01 009 ANOSTYF1 117-120 Record 01 009 ANOSTYF2 121-124 Record 01 009 ===== C ===== CONCD1 047-051 Record 01 004 CONCD2 052-056 Record 01 004 ===== E ===== EMPYD 127 Record 01 009 ===== H ===== HRDYWK 085-087 Record 01 005 HRSEPM 128-130 Record 01 009 HSPNIT 036-038 Record 01 002 ===== I ===== ICTMFLG 111-116 Record 01 009 INSURFLG 133 Record 01 010 ===== O ===== OSCODE 073-074 Record 01 005 ===== 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 ===== REASONS (039-046) Record 01 003 REC 010-011 Record 01 001 RELAT 131-132 Record 01 010 ===== S ===== SBPS 106 Record 01 009 SDRUGCD 075-078 Record 01 005 INDEX OF VARIABLES PAGE 002 Variable Name Column Numbers Record Number Codebook Page No. ------------- -------------- ------------- ----------------- ===== S ===== SFORM 014 Record 01 001 SFPART 015-016 Record 01 001 SHH_COUN 070 Record 01 005 SHH_HOUS 069 Record 01 005 SHH_MEAL 071 Record 01 005 SHH_MED 067 Record 01 004 SHH_OTH 072 Record 01 005 SHH_PER 068 Record 01 004 SHSTAYFG 107-110 Record 01 009 SMELSPY 095 Record 01 006 SRBEGDY 026-027 Record 01 002 SRBEGMO 024-025 Record 01 002 SRBEGYR 028-029 Record 01 002 SRE_CAID 096 Record 01 006 SRE_CARE 099 Record 01 007 SRE_DOL 088-093 Record 01 006 SRE_EOS 102-103 Record 01 008 SRE_EVNT 079-084 Record 01 005 SRE_NOPY 104-105 Record 01 008 SRE_OTHR 101 Record 01 008 SRE_PRVI 098 Record 01 007 SRE_PUB 097 Record 01 007 SRE_RES 100 Record 01 007 SRE_UC 094 Record 01 006 SREASON1 039-040 Record 01 003 SREASON2 041-042 Record 01 003 SREASON3 043-044 Record 01 003 SREASON4 045-046 Record 01 004 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 01 006