/* SHORT TITLE: Codebook for Patient Quest-Time 6 Specific Data */
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* W E S T A T C O D E B O O K *
* ----------- --------------- *
* *
* STUDY OF HEALTH CARE COSTS *
* WESTAT ADULT QUESTIONNAIRE TIME 6 - PUBLIC USE *
* 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 *
* WESTAT ADULT QUESTIONNAIRE TIME 6 - PUBLIC USE *
* 30 JUNE 1994 *
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(0)
27 Jun. 1994
Record 01
STUDY OF HEALTH CARE COSTS
WESTAT ADULT QUESTIONNAIRE TIME 6 - PUBLIC USE
30 JUNE 1994
Question Column
Name Number(s)
________ _________
IPID01 001-009 PATIENT ID NUMBER
_________________
000000001-
999999999 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
IREC01 010-011 RECORD NUMBER
_____________
01 = NUMBER
ISREC01 012-013 SUBRECORD NUMBER
________________
00 = NOT A REPEATING RECORD
IITYPE 014 WHAT IS THE INSTRUMENT TYPE?
_____________________________
I = INSTRUMENT TYPE
IRTYPE 015 RESPONDENT TYPE
_______________
1 = STUDY SUBJECT
2 = PROXY
ILANG 016 QUESTIONNAIRE LANGUAGE VERSION
______________________________
1 = ENGLISH
2 = SPANISH
IREFDT (017-022) REFERENCE BEGIN DATE
____________________
IREFMO 017-018 REFERENCE BEGIN MONTH
_____________________
01-12 = MONTH
(1)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IREFDY 019-020 REFERENCE BEGIN DAY
___________________
01-31 = DAY
IREFYR 021-022 REFERENCE BEGIN YEAR
____________________
91-92 = YEAR
IENDDT (023-028) REFERENCE END DATE
__________________
IENDMO 023-024 REFERENCE END MONTH
___________________
01-12 = MONTH
IENDDY 025-026 REFERENCE END DAY
_________________
01-31 = DAY
IENDYR 027-028 REFERENCE END YEAR
__________________
91-92 = YEAR
T6_STAT 029-030 QUESTIONNAIRE STATUS
____________________
CO = COMPLETE, WITH RESPONDENT
PR = COMPLETE, WITH PROXY
DD = COMPLETE, WITH PROXY PATIENT DECEASED AT TIME OF INTERVIEW
OBSDAYS6 031-033 OBSERVATION DAYS WITHIN REFERENCE PERIOD EXCLUDING PERIODS OF INELIGIBILITY
___________________________________________________________________________
001-600 = NUMBER
999 = NOT ASCERTAINED
(2)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
GAP6FLAG 034 PATIENT HAD TIME GAP DURIMG THE REFERENCE PERIOD
________________________________________________
+ = INAPPLICABLE, NO TIME GAP
1 = YES TIME GAP
ADM6 035-036 NUMBER OF INPATIENT ADMISSIONS (UNSTANDARDIZED)
_______________________________________________
00 = NONE
01-99 = NUMBER OF ADMISSIONS
IPNGT6 037-039 NUMBER OF INPATIENT NIGHTS (UNSTANDARDIZED)
___________________________________________
000 = NONE
001-999 = NUMBER OF NIGHTS
AMBVS6 040-042 NUMBER OF AMBULATORY VISITS, INCLUDES HOSPITAL CLINIC, OTHER CLINIC AND PRIVATE MD
(UNSTANDARDIZED)
________________
000 = NONE
001-999 = NUMBER OF AMBULATORY VISITS
ERVS6 043-045 NUMBER OF EMERGENCY ROOM VISITS (UNSTANDARDIZED)
________________________________________________
000 = NONE
001-999 = NUMBER OF EMERGENCY ROOM VISITS
HCVS6 046-048 NUMBER OF HOSPITAL CLINIC VISITS (UNSTANDARDIZED)
_________________________________________________
000 = NONE
001-999 = NUMBER OF HOSITAL CLINIC VISITS
OCVS6 049-051 NUMBER OF OTHER CLINIC VISITS (UNSTANDARDIZED)
______________________________________________
000 = NONE
001-999 = NUMBER OF OTHER CLINIC VISITS
(3)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
MDVS6 052-054 NUMBER OF PRIVATE MD VISITS (UNSTANDARDIZED)
____________________________________________
000 = NONE
001-999 = NUMBER OF PRIVATE MD VISITS
IHSEHOLD (055-129) HOUSEHOLD COMPOSITION
_____________________
IA01CT 055-056 COUNTER OF PEOPLE LISTED IN Q.A1.
__________________________________
00 = NONE
01-10 = AMOUNT
* SKIP IA1REL1 - IA1SST10
PERSON1 (057-062) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL1 057-058 RELATIONSHIP
____________
+ = INAPPLICABLE, NO NAMES LISTED (PATIENT LIVES ALONE)
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX1 059 SEX
___
+ = INAPPLICABLE, NO NAMES LISTED (PATIENT LIVES ALONE)
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(4)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE1 060-061 AGE
___
+ = INAPPLICABLE, NO NAMES LISTED (PATIENT LIVES ALONE)
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST1 062 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, NO NAMES LISTED (PATIENT LIVES ALONE)
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON2 (063-068) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL2 063-064 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX2 065 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(5)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE2 066-067 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST2 068 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON3 (069-074) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL3 069-070 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX3 071 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(6)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE3 072-073 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST3 074 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON4 (075-080) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL4 075-076 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX4 077 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(7)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE4 078-079 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST4 080 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON5 (081-086) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL5 081-082 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX5 083 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(8)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE5 084-085 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST5 086 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON6 (087-092) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL6 087-088 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX6 089 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(9)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE6 090-091 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST6 092 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON7 (093-098) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL7 093-094 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX7 095 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(10)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE7 096-097 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST7 098 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON8 (099-104) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL8 099-100 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX8 101 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(11)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE8 102-103 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST8 104 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON9 (105-110) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL9 105-106 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX9 107 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(12)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE9 108-109 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST9 110 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
PERSON10 (111-116) HOW IS THIS PERSON RELATED TO (PATIENT)? IS (PERSON) MALE OR FEMALE? HOW OLD IS
(PERSON)?
__________
IA1REL10 111-112 RELATIONSHIP
____________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
01-21 = USE CODES IN APPENDIX 55
91 = OTHER RELATIVE
92 = OTHER NON -RELATIVE
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SEX10 113 SEX
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = MALE
2 = FEMALE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(13)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA1AGE10 114-115 AGE
___
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
00 = NEWBORN TO 11 MONTHS
01-90 = YEARS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA1SST10 116 HAS (PERSON) BEEN DIAGNOSED AS BEING HIV POSITIVE?
___________________________________________________
+ = INAPPLICABLE, PATIENT LIVES ALONE, OR NO OTHER NAMES LISTED
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IABOX1 (117-118) BOX A -1
________
IABOX1A 117 CHILDREN LISTED?
_________________
1 = YES
2 = NO
IABOX1B 118 SPOUSE/PARTNER LISTED?
_______________________
* 1 = YES
2 = NO
* SKIP IA2 - IA4
(14)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA2 119 ON AUGUST 31, 1992 WERE YOU CURRENTLY LEGALLY MARRIED, WIDOWED, DIVORCED, SEPARATED, OR
HAVE YOU NEVER BEEN MARRIED?
_____________________________
+ = INAPPLICABLE, CODED 1 IN IABOX1B
* 1 = MARRIED
2 = WIDOWED
3 = DIVORCED
4 = SEPARATED
5 = NEVER MARRIED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IA3
IA3 120 ON AUGUST 31, 1992 WERE YOU CURRENTLY INVOLVED IN A COMMITTED RELATIONSHIP WITH ONE OTHER
PERSON?
________
+ = INAPPLICABLE, CODED 1 IN IABOX1B; OR CODED 1 IN IA2.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IA4
IA4 121 HAS (YOUR SPOUSE/THAT PERSON) ALSO BEEN DIAGNOSED AS BEING HIV POSITIVE?
_________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IABOX1B; OR CODED 2, 7, 8 OR 9 IN IA3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(15)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA5 122-123 PLEASE LOOK AT THIS CARD, WHICH DESCRIBES DIFFERENT TYPES OF PLACES WHERE PEOPLE LIVE.
BETWEEN (REF. DATE), AND AUGUST 31, 1992, IN WHICH ONE OF THESE TYPES OF PLACES DID YOU
LIVE MOST OF THE TIME? CODE ONE.
__________________________________
01 = APARTMENT OR HOUSE WHICH YOU OWN OR HOLD THE LEASE
02 = APARTMENT OR HOUSE OF ANOTHER IN WHICH YOU PAY RENT BUT DON'T HOLD THE
LEASE
03 = "DOUBLED UP" WITH FRIEND OR RELATIVE ON SOFA, FLOOR, ETC.
04 = SINGLE ROOM OCCUPANCY (SRO) OR 'WELFARE HOTEL'
05 = SPECIALIZED AIDS HOUSING
06 = SHELTERS
07 = STREET OR OTHER PUBLIC PLACE
08 = HOSPITAL, NURSING HOME, RESIDENTIAL CARE FACILITY
09 = IN FOSTER HOMES
10 = LIVES WITH SOMEONE ELSE
11 = JAIL
12 = PUBLIC HOUSING
13 = TRAILER/HOUSE UNKNOWN IF OWNED/LEASED
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IA6 (124-129) PLEASE LOOK AT THIS CARD. BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID YOU LIVE IN ANY
OF THESE PLACES OR SITUATIONS? (CODE ALL THAT APPLY)
_____________________________________________________
IA6A 124 TEMPORARILY "DOUBLED UP" WITH FRIEND OR RELATIVE ON SOFA, FLOOR, ETC.
______________________________________________________________________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IA6B 125 SINGLE ROOM OCCUPANCY (SRO) OR 'WELFARE HOTEL'
______________________________________________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(16)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IA6C 126 SPECIALIZED AIDS HOUSING
________________________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IA6D 127 SHELTERS
________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IA6E 128 STREET OR OTHER PUBLIC PLACE
____________________________
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IA6F 129 NONE
____
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IINSCOVR (130-220) INSURANCE COVERAGE
__________________
(17)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB1 130 BETWEEN (REF. DATE) AND AUGUST 31, 1992, HAVE YOU BEEN COVERED BY ANY PRIVATE HEALTH
INSURANCE PLAN, INCLUDING AN HMO, THAT PAYS FOR ANY PART OF HOSPITAL BILLS, DOCTOR BILLS,
OR SURGEON BILLS?
__________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IBBOX2
IBBOX2 131 TIME 5 = PRIVATE INSURANCE
__________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB1
* 1 = YES
** 2 = NO
* SKIP IBBOX3
** SKIP IBBOX3 - IB6
IBBOX3 132 TIME 5 = PRIVATE INSURANCE
__________________________
+ = INAPPLICABLE, CODED 1 IN IB1
* 1 = YES
** 2 = NO
* SKIP IB2 - IB4L
** SKIP IB2 - IB10
IB2 133 IS THIS THE SAME PRIVATE HEALTH INSURANCE PLAN YOU TOLD ME ABOUT LAST TIME?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IBBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB3 - IB4L
(18)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB3 134 HAVE YOU BEEN COVERED THE WHOLE TIME BETWEEN (REF. DATE) AND AUGUST 31, 1992, OR ONLY
PART OF THE TIME?
__________________
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IBBOX3; OR CODED 2, 7 OR 9 IN
IB2.
* 1 = THE WHOLE TIME
2 = PART OF THE TIME
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB4A - IB10
IB4 (135-146) BETWEEN (REF. DATE) AND AUGUST 31, 1992, IN WHICH MONTHS WERE YOU COVERED BY PRIVATE
INSURANCE FOR THE ENTIRE MONTH? CIRCLE THE CODE FOR ALL MONTHS 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).
IB4A 135 JANUARY
_______
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB4B 136 FEBRUARY
________
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(19)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB4C 137 MARCH
_____
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB4D 138 APRIL
_____
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB4E 139 MAY
___
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB4F 140 JUNE
____
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
(20)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB4G 141 JULY
____
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB4H 142 AUGUST
______
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB4I 143 SEPTEMBER
_________
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB4J 144 OCTOBER
_______
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
(21)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB4K 145 NOVEMBER
________
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB4L 146 DECEMBER
________
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED IN IBBOX3; OR CODED 2, 7 OR 9
IN IB2; OR CODED 1, 7, 8 OR 9 IN IB3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
GO TO IB12
IB5 (147-150) WHEN DID YOUR (PREVIOUS) HEALTH INSURANCE COVERAGE END?
CODER: IF IB5YR EQUALS 97, 98 OR 99, CODE 99 IN IB5MO.
IB5MO 147-148 MONTH
_____
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED 2 IN IBBOX3; OR CODED 1 OR 8 IN
IB2.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(22)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB5YR 149-150 YEAR
____
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED 2 IN IBBOX3; OR CODED 1 OR 8 IN
IB2.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB6 151 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED?
_________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED 2 IN IBBOX3; OR CODED 1 OR 8 IN
IB2.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IBBOX4 152 LOOK AT Q. B-1. R ANSWERED:
______________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX2; OR CODED 2 IN IBBOX3; OR CODED 1 OR 8 IN
IB2.
1 = YES
* 2 = NO
* SKIP IB7 - IB10
IB7 153 IS THIS PLAN INDIVIDUAL OR FAMILY COVERAGE?
____________________________________________
+ = INAPPLICABLE, CODED ONLY IF IBBOX2 = 2; OR IF IBBOX4 = 1.
1 = INDIVIDUAL PLAN
2 = FAMILY PLAN
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(23)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB8 154-155 HOW DO YOU GET THIS HEALTH INSURANCE OR HEALTH PLAN - THROUGH AN EMPLOYER OR FAMILY
BUSINESS, A UNION, OR SOME OTHER GROUP, OR DIRECTLY FROM AN INSURANCE COMPANY?
_______________________________________________________________________________
+ = INAPPLICABLE, CODED ONLY IF IBBOX2 = 2; OR IF IBBOX4 = 1.
01 = EMPLOYER/FAMILY BUSINESS
02 = UNION
03 = INSURANCE COMPANY
04 = SCHOOL ALUMNI GROUP/OTHER SPECIAL INTEREST GROUP/PROFESSIONAL GROUP
05 = PUBLIC ASSISTANCE/MEDICAL ASSISTANCE
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB9 (156-159) WHEN DID THIS HEALTH INSURANCE BEGIN?
CODER: IF IB9YR EQUALS 97, 98 OR 99, CODE 99 IN IB9MO.
IB9MO 156-157 MONTH
_____
+ = INAPPLICABLE, CODED ONLY IF IBBOX2 = 2; OR IF IBBOX4 = 1.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB9YR 158-159 YEAR
____
+ = INAPPLICABLE, CODED ONLY IF IBBOX2 = 2; OR IF IBBOX4 = 1.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(24)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB10 160 IS THIS PLAN A HEALTH MAINTENANCE ORGANIZATION OR HMO?
_______________________________________________________
+ = INAPPLICABLE, CODED ONLY IF IBBOX2 = 2; OR IF IBBOX4 = 1.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB12 161 AT ANY TIME BETWEEN (REF. DATE) AND AUGUST 31, 1992, HAVE YOU BEEN COVERED BY
(MEDICAID/STATE NAME FOR MEDICAID)?
____________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB13 - IB14L
IB13 162 HAVE YOU BEEN COVERED THE WHOLE TIME BETWEEN (REF. DATE) AND AUGUST 31, 1992, UNTIL
TODAY, OR ONLY PART OF THE TIME?
_________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12.
* 1 = THE WHOLE TIME
2 = PART OF THE TIME
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB14A - IB14L
IB14 (163-174) BETWEEN (REF. DATE) AND AUGUST 31, 1992, IN WHICH MONTHS WERE YOU COVERED BY
(MEDICAID/STATE NAME FOR MEDICAID) FOR THE ENTIRE MONTH? CIRCLE THE CODE FOR ALL MONTHS
THAT APPLY.
CODER: AT LEAST ONE MONTH MUST BE CIRCLED. IF NONE ARE CIRCLED, CODE 9 FOR EACH MONTH.
IF AT LEAST ONE ITEM IS CIRCLED, CODE 1 FOR ALL CIRLCED ITEM(S). CODE 2 FOR ALL
UNCIRCLED ITEM(S).
(25)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB14A 163 JANUARY
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB14B 164 FEBRUARY
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB14C 165 MARCH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB14D 166 APRIL
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(26)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB14E 167 MAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB14F 168 JUNE
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB14G 169 JULY
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB14H 170 AUGUST
______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
(27)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB14I 171 SEPTEMBER
_________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB14J 172 OCTOBER
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB14K 173 NOVEMBER
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB14L 174 DECEMBER
________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB12; OR CODED 1, 7, 8 OR 9 IN IB13.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
GO TO IB19
(28)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IBBOX5 175 TIME 3 = MEDICAID
_________________
+ = INAPPLICABLE, CODED 1 IN IB12.
1 = YES
* 2 = NO
* SKIP IB16MO - IB16YR
IB16 (176-179) WHEN DID YOUR (MEDICAID/STATE NAME FOR MEDICAID) COVERAGE END?
CODER: IF IB16YR EQUALS 97, 98 OR 99, CODE 99 IN IBI6MO.
IB16MO 176-177 MONTH
_____
+ = INAPPLICABLE, CODED 2 IN IBBOX5; CODED 1 IN IB12.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB16YR 178-179 YEAR
____
+ = INAPPLICABLE, CODED 2 IN IBBOX5; CODED 1 IN IB12.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB17 180 BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID YOU (RE-)APPLY FOR MEDICAID?
___________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IB12.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB18
(29)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB18 181 WERE YOU TURNED DOWN FOR MEDICAID?
___________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB17; OR CODED 1 IN IB12.
1 = YES
2 = NO/ NO DECISION YET
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB19 182 BETWEEN (REF. DATE) AND AUGUST 31, 1992, HAVE YOU BEEN COVERED BY MEDICARE? MEDICARE IS
A SOCIAL SECURITY HEALTH INSURANCE PROGRAM FOR DISABLED PERSONS AND FOR PERSONS 65 YEARS
OLD AND OLDER.
_______________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB21 183 BETWEEN (REF. DATE) AND AUGUST 31,HAVE YOU BEEN COVERED BY ANY OTHER PUBLIC ASSISTANCE
PROGRAM (BESIDES MEDICAID/STATE NAME FOR MEDICAID OR MEDICARE) THAT PAYS FOR MEDICAL CARE
_________________________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IBBOX6
IBBOX6 184 TIME 5 = OTHER PUBLIC ASSISTANCE
________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB21.
* 1 = YES
** 2 = NO
* SKIP IBBOX7
** SKIP IBBOX7 - IBBOX8
(30)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IBBOX7 185 TIME 5 = OTHER PUBLIC ASSISTANCE
________________________________
+ = INAPPLICABLE, CODED 1 IN IB21.
* 1 = YES
** 2 = NO
* SKIP IB22 - IB24L
** SKIP IB22 - IB27YR
IB22 186 IS THIS THE SAME PUBLIC ASSISTANCE PROGRAM YOU TOLD ME ABOUT LAST TIME?
________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB23 - IB24L
IB23 187 WERE YOU COVERED THE WHOLE TIME FROM (REF. DATE) UNTIL AUGUST 31, 1992, OR ONLY PART OF
THE TIME?
__________
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22.
* 1 = THE WHOLE TIME
2 = PART OF THE TIME
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB24A - IB27YR
IB24 (188-199) BETWEEN (REF. DATE) AND AUGUST 31, 1992, IN WHICH MONTHS WERE YOU COVERED BY (OTHER
PUBLIC ASSISTANCE PROGRAM) FOR THE ENTIRE MONTH? CIRCLE THE CODE FOR ALL MONTHS 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).
(31)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB24A 188 JANUARY
_______
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB24B 189 FEBRUARY
________
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB24C 190 MARCH
_____
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB24D 191 APRIL
_____
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(32)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB24E 192 MAY
___
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB24F 193 JUNE
____
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB24G 194 JULY
____
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB24H 195 AUGUST
______
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
(33)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB24I 196 SEPTEMBER
_________
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB24J 197 OCTOBER
_______
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB24K 198 NOVEMBER
________
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB24L 199 DECEMBER
________
+ = INAPPLICABLE, CODED 2 IN IBBOX6; OR CODED IN IBBOX7; OR CODED 2, 7, 8 OR
9 IN IB22; OR CODED 1, 7, 8 OR 9 IN IB23.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
GO TO IBB0X9
(34)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB25 (200-203) (LAST TIME YOU TOLD ME YOU WERE COVERED BY SOME PUBLIC ASSISTANCE PROGRAM.) WHEN DID YOUR
COVERAGE UNDER THAT PROGRAM END?
CODER: IF IB25YR EQUALS 97, 98 OR 99, CODE 99 IN IB25MO.
IB25MO 200-201 MONTH
_____
+ = INAPPLICABLE, CODED ONLY IF IBBOX7 = 1; OR IB22 = 2, 7, 8 OR 9.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB25YR 202-203 YEAR
____
+ = INAPPLICABLE, CODED ONLY IF IBBOX7 = 1; OR IB22 = 2, 7, 8 OR 9.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IBBOX8 204 LOOK AT Q B-21. R ANSWERED:
_____________________________
+ = INAPPLICABLE, CODED ONLY IF IBBOX7 = 1; OR IB22 = 2, 7, 8 OR 9.
1 = YES
* 2 = NO
* SKIP IB26 - IB27YR
(35)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB26 205-206 WHAT IS THE NAME OF THIS PROGRAM?
__________________________________
+ = INAPPLICABLE, CODED ONLY IF IBBOX6 = 2; OR IBBOX8 = 1.
70 = DRUG ASSISTANCE PROGRAM
71 = ASSISTANCE FROM PROVIDER-FUNDING UNKNOWN
72 = CITY FUNDED PROGRAM
73 = COUNTY FUNDED PROGRAM
74 = STATE FUNDED PROGRAM
75 = FEDERALLY FUNDED PROGRAM
76 = GOVT FUNDED PROGRAM, NOS
77 = COMMUNITY PROGRAM -FUNDING UNKNOWN
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB27 (207-210) WHEN DID YOUR COVERAGE UNDER THIS CURRENT PROGRAM BEGIN?
CODER: IF IB27YR EQUALS 97, 98 OR 99, CODE 99 IN IB27MO.
IB27MO 207-208 MONTH
_____
+ = INAPPLICABLE, CODED ONLY IF IBBOX6 = 2; OR IBBOX8 = 1.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB27YR 209-210 YEAR
____
+ = INAPPLICABLE, CODED ONLY IF IBBOX6 = 2; OR IBBOX8 = 1.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(36)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IBBOX9 211 TIME 5 - CHAMPUS/CHAMPVA
________________________
1 = YES
* 2 = NO
* SKIP IB28
IB28 212 ON AUGUST 31, 1992, WERE YOU COVERED BY CHAMPUS (WHICH COVERS BOTH ACTIVE DUTY AND
RETIRED CAREER MILITARY PERSONNEL, THEIR DEPENDENTS AND SURVIVORS) OR CHAMPVA (WHICH
COVERS DISABLED VETERANS, THEIR DEPENDENTS, AND SURVIVORS?)
___________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX9
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB29 213 ON AUGUST 31, 1992, WERE YOU PARTICIPATING IN ANY CLINICAL TRIALS FOR ANY MEDICATIONS?
_______________________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB31A1 - IB31B2
IB31 (214-219) HOW LONG HAVE YOU BEEN PARTICIPATING IN THIS/THESE TRIALS?
___________________________________________________________
IB31A (214-216) LENGTH OF TIME IN FIRST TRIAL
_____________________________
(37)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB31A1 214-215 LENGTH OF TIME 1
________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB29.
01-90 = LENGTH
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IB31A2
IB31A2 216 UNIT OF TIME 1
______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB29; OR CODED 97, 98 OR 99 IN IB31A1
1 = DAYS
2 = WEEKS
3 = MONTHS
4 = YEARS
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IB31B (217-219) LENGTH OF TIME IN SECOND TRIAL
______________________________
IB31B1 217-218 LENGTH OF TIME 2
________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB29; OR ONLY ONE TRIAL.
01-90 = AMOUNT
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IB31B2
(38)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB31B2 219 UNIT OF TIME 2
______________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IB29; OR ONLY ONE TRIAL.
1 = DAYS
2 = WEEKS
3 = MONTHS
4 = YEARS
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IBBOX10 220 DOES R HAVE PRIVATE INSURANCE?
_______________________________
1 = YES
* 2 = NO
* SKIP IB32 - IB36G2
* SKIP IB363 - IB36G5
PRVI (221) PRIVATE INSURANCE WORKSHEET
___________________________
IB32 221-226 WHAT IS THE PREMIUM OR PAYMENT (OR PART OF THE PREMIUM) THAT YOU PAY FOR YOUR HEALTH
INSURANCE? DO NOT INCLUDE ANY AMOUNT PAID BY YOUR EMPLOYER OR ANY OTHER SOURCE.
_________________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10.
* 000000 = NOTHING
000001-999996 = AMOUNT PAID
* 999997 = REFUSED
* 999998 = DK
* 999999 = NOT ASCERTAINED
* SKIP IB33
(39)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB33 227-228 IS THIS AMOUNT YOU PAY PER WEEK, PER MONTH, PER YEAR OR SOME OTHER PERIOD?
___________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10 AND CODED NONE OR 97, 98 OR 99 IN IB32
01 = PER WEEK
02 = PER MONTH
03 = QUARTERLY
04 = SEMI - ANNUALLY (EVERY 6 MONTHS)
05 = PER YEAR
06 = TWO TIMES A MONTH/BIWEEKLY
07 = EVERY TWO MONTHS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IB34 229 DO YOU HAVE A DEDUCTIBLE? PROBE: IS THERE A SPECIFIC DOLLAR AMOUNT THAT YOU PAY OF
HEALTH CARE EXPENSES BEFORE YOUR INSURANCE COMPANY BEGINS TO PAY?
__________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB35A - IB35B
IB35 (230-236) HOW MUCH IS YOUR DEDUCTIBLE?
_____________________________
IB35A 230-235 AMOUNT
______
+ = INAPPLICABLE, CODED 2 IN IBBOX10, OR CODED 2, 7, 8 OR 9 IN IB34;
000001-999996 = AMOUNT
* 999997 = REFUSED
* 999998 = DK
* 999999 = NOT ASCERTAINED
* SKIP IB35B
(40)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB35B 236 IS DEDUCTIBLE DOLLAR AMOUNT OR PERCENTAGE?
___________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB34; OR CODED
97, 98 OR 99 IN IB35A
1 = AMOUNT IN DOLLARS
2 = PERCENTAGE
IB361 237 DOES YOUR INSURANCE PAY FOR SERVICES WHEN YOU ARE HOSPITALIZED?
________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36A1 - IB36G1
IB36A1 238 DO YOU HAVE A CO-PAYMENT, THAT IS, DO YOU HAVE TO PAY SOME OF THE COST OUT OF YOUR OWN
POCKET WHEN YOU ARE HOSPITALIZED?
__________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB361;
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB36B1 239 IS THERE A PERCENTAGE APPLIED TO THIS BILL, FOR EXAMPLE, YOU WOULD PAY 20% AND THE
INSURANCE COMPANY PAYS 80%, OR DO YOU PAY A FLAT RATE PER HOSPITALIZATION?
___________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB361.
1 = PERCENTAGE
* 2 = FLAT FEE
** 7 = REFUSED
** 8 = DK
** 9 = NOT ASCERTAINED
* SKIP IBR1 - IBINS1
** SKIP IBR1 - IB36D1
(41)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36C1 (240-245) WHAT ARE THESE PERCENTAGES?
____________________________
IBR1 240-242 PERCENTAGE PAID BY RESPONDENT
_____________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10, OR CODED 2, 7, 8 OR 9 IN IB361; OR
CODED 2, 7, 8 OR 9 IN IB361.
001-100 = PERCENTAGE
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IBINS1 243-245 PERCENTAGE PAID BY INSURANCE COMPANY
____________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10, OR CODED 2, 7, 8 OR 9 IN IB361; OR
CODED 2, 7, 8 OR 9 IN IB361.
001-100 = PERCENTAGE
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IB36D1 246-251 HOW MUCH DO YOU PAY PER (HOSPITALIZATION)?
___________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB361; OR
CODED 1, 7, 8 OR 9 IN IB36B1.
000001-999996 = AMOUNT
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
IB361E (252-255) IS THERE A SPECIFIED NUMBER OF DAYS THAT ARE FREE?
___________________________________________________
(42)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36E1 252 IS THERE A SPECIFIED NUMBER OF DAYS THAT ARE FREE (HOSPITALIZATION)?
_____________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB36B1.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IBDAYS1
IBDAYS1 253-255 HOW MANY DAYS ARE FREE (HOSPITALIZATION)?
__________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB36B1; OR
CODED 2, 7, 8 OR 9 IN IB36E1.
001-996 = NUMBER OF DAYS
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IB36F1 256 DOES THIS CHANGE AFTER YOU HAVE REACHED A SPECIFIED AMOUNT?
____________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB36B1.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36G1
(43)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36G1 257-260 HOW DOES IT CHANGE?
____________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB36B1; OR
CODED 2, 7, 8 OR 9 IN IB36F1.
0001 = INSURANCE PAYS 100% AFTER SPECIFIED AMOUNT
0002 = LIFETIME LIMIT SPECIFIED
0003 = INSURANCE PAYS 100% UP TO LIFETIME MAXIMUM/YEARLY MAXIMUM
0004 = SPECIFIED TIME LIMIT OR NUMBER OF TIMES/THEN PATIENT MUST PAY
0005 = LIMIT GIVEN BUT NOT SPECIFIED IF YEARLY/LIFETIME
0006 = INSURANCE PAYS 80% UP TO LIMIT
0007 = INSURANCE PAYS UP TO USUAL AND CUSTOMARY PATIENT PAYS REST
0008 = YEARLY MAXIMUM SPECIFIED
0009 = INSURANCE PAYS 100% UP TO LIMIT
0010 = 90% OF USUAL AND CUSTOMARY
0011 = PREAPPROVED - 100%
0012 = INSURANCE PAYS 100% TO LIMIT THEN 80%
0013 = COPAY AMOUNT INCREASES AFTER SET AMOUNT OF VISITS/$ AMOUNT
9991 = OTHER SPECIFIED
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IB362 261 DOES YOUR INSURANCE PAY FOR SERVICES WHEN YOU MAKE A DOCTOR'S VISIT?
_____________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36A2 - IB36G2
IB36A2 262 DO YOU HAVE A CO-PAYMENT, THAT IS, DO YOU HAVE TO PAY SOME OF THE COST OUT OF YOUR OWN
POCKET WHEN YOU MAKE A DOCTOR VISIT?
_____________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB362.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(44)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36B2 263 IS THERE A PERCENTAGE APPLIED TO THIS BILL, FOR EXAMPLE, YOU WOULD PAY 20% AND THE
INSURANCE COMPANY PAYS 80%, OR DO YOU PAY A FLAT RATE PER INCIDENT?
____________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB362.
1 = PERCENTAGE
* 2 = FLAT RATE
** 7 = REFUSED
** 8 = DK
** 9 = NOT ASCERTAINED
* SKIP IBR2 - IBINS2
** SKIP IBR2 - IB36D2
IB36C2 (264-269) PERCENTAGES PAID BY RESPONDENT AND INSURANCE COMPANY
____________________________________________________
IBR2 264-266 PERCENTAGE PAID BY RESPONDENT
_____________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB362; OR
CODED 2, 7, 8 OR 9 IN IB36B2.
001-100 = PERCENTAGE
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IBINS2 267-269 PERCENTAGE PAID BY INSURANCE COMPANY
____________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB362; OR
CODED 2, 7, 8 OR 9 IN IB36B2.
* 001-100 = PERCENTAGE
* 997 = REFUSED
* 998 = DK
* 999 = NOT ASCERTAINED
* SKIP IB36D2L
(45)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36D2 270-275 HOW MUCH DO YOU PAY PER DOCTOR VISIT?
______________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB36B2; OR
CODED 1, 7, 8 OR 9 IN IB36B2.
000001-999996 = AMOUNT
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
IB36F2 276 DOES THIS CHANGE AFTER YOU HAVE REACHED A SPECIFIED AMOUNT?
____________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB362.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36G2
IB36G2 277-280 HOW DOES IT CHANGE?
____________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB362; OR
CODED 2, 7, 8 OR 9 IN IB36F2.
0001 = INSURANCE PAYS 100% AFTER SPECIFIED AMOUNT
0002 = LIFETIME LIMIT SPECIFIED
0003 = INSURANCE PAYS 100% UP TO LIFETIME MAXIMUM/YEARLY MAXIMUM
0004 = SPECIFIED TIME LIMIT OR NUMBER OF TIMES/THEN PATIENT MUST PAY
0005 = LIMIT GIVEN BUT NOT SPECIFIED IF YEARLY/LIFETIME
0006 = INSURANCE PAYS 80% UP TO LIMIT
0007 = INSURANCE PAYS UP TO USUAL AND CUSTOMARY PATIENT PAYS REST
0008 = YEARLY MAXIMUM SPECIFIED
0009 = INSURANCE PAYS 100% UP TO LIMIT
0010 = 90% OF USUAL AND CUSTOMARY
0011 = PREAPPROVED - 100%
0012 = INSURANCE PAYS 100% TO LIMIT THEN 80%
0013 = COPAY AMOUNT INCREASES AFTER SET AMOUNT OF VISITS/$ AMOUNT
9991 = OTHER SPECIFIED
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
(46)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB363 281 DOES YOUR INSURANCE PAY FOR PRESCRIPTIONS?
___________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36A3 - IB36G3
IB36A3 282 DO YOU HAVE A CO-PAYMENT, THAT IS, DO YOU HAVE TO PAY SOME OF THE COST OUT OF YOUR OWN
POCKET WHEN YOU FILL PRESCRIPTIONS?
____________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB363.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB36B3 283 IS THERE A PERCENTAGE APPLIED TO THIS BILL, FOR EXAMPLE, YOU WOULD PAY 20% AND THE
INSURANCE COMPANY PAYS 80%, OR DO YOU PAY A FLAT RATE PER PRESCRIPTION?
________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB363.
1 = PERCENTAGE
* 2 = FLAT FEE
** 7 = REFUSED
** 8 = DK
** 9 = NOT ASCERTAINED
* SKIP IBR3 - IBINS3
** SKIP IBR3 - IB36D3
IB36C3 (284-289) PERCENTAGES PAID BY RESPONDENT AND INSURANCE COMPANY
____________________________________________________
(47)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IBR3 284-286 PERCENTAGE PAID BY RESPONDENT
_____________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB363; OR
CODED 2, 7, 8 OR 9 IN IB36B3.
001-100 = PERCENTAGE
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IBINS3 287-289 PERCENTAGE PAID BY INSURANCE COMPANY
____________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB363; OR
CODED 2, 7, 8 OR 9 IN IB36B3.
* 001-100 = PERCENTAGE
* 997 = DK
* 998 = REFUSED
* 999 = NOT ASCERTAINED
* SKIP IB36D3
IB36D3 290-295 HOW MUCH DO YOU PAY PER PRESCRIPTION?
______________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB363; OR
CODED 1, 7, 8 OR 9 IN IB36B3.
000001-999996 = AMOUNT
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
IB36F3 296 DOES THIS CHANGE AFTER YOU HAVE REACHED A SPECIFIED AMOUNT?
____________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB363.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36G3
(48)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36G3 297-300 HOW DOES IT CHANGE?
____________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB363; OR
CODED 2, 7, 8 OR 9 IN IB36F3.
0001 = INSURANCE PAYS 100% AFTER SPECIFIED AMOUNT
0002 = LIFETIME LIMIT SPECIFIED
0003 = INSURANCE PAYS 100% UP TO LIFETIME MAXIMUM/YEARLY MAXIMUM
0004 = SPECIFIED TIME LIMIT OR NUMBER OF TIMES/THEN PATIENT MUST PAY
0005 = LIMIT GIVEN BUT NOT SPECIFIED IF YEARLY/LIFETIME
0006 = INSURANCE PAYS 80% UP TO LIMIT
0007 = INSURANCE PAYS UP TO USUAL AND CUSTOMARY PATIENT PAYS REST
0008 = YEARLY MAXIMUM SPECIFIED
0009 = INSURANCE PAYS 100% UP TO LIMIT
0010 = 90% OF USUAL AND CUSTOMARY
0011 = PREAPPROVED - 100%
0012 = INSURANCE PAYS 100% TO LIMIT THEN 80%
0013 = COPAY AMOUNT INCREASES AFTER SET AMOUNT OF VISITS/$ AMOUNT
9991 = OTHER SPECIFIED
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IB364 301 DOES YOUR INSURANCE PAY FOR MENTAL HEALTH SERVICES?
____________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36A4 - IB36G4
IB36A4 302 DO YOU HAVE A CO-PAYMENT, THAT IS, DO YOU HAVE TO PAY SOME OF THE COST OUT OF YOUR OWN
POCKET WHEN YOU RECEIVE MENTAL HEALTH SERVICES?
________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB364.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(49)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36B4 303 IS THERE A PERCENTAGE APPLIED TO THIS BILL, FOR EXAMPLE, YOU WOULD PAY 20% AND THE
INSURANCE COMPANY PAYS 80%, OR DO YOU PAY A FLAT RATE PER INCIDENT?
____________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB364.
1 = PERCENTAGE
* 2 = FLAT FEE
** 7 = REFUSED
** 8 = DK
** 9 = NOT ASCERTAINED
* SKIP IBR4 - IBINS4
** SKIP IBR4 - IB36D4
IB36C4 (304-309) PERCENTAGES PAID BY RESPONDENT AND INSURANCE COMPANY
____________________________________________________
IBR4 304-306 PERCENTAGE PAID BY RESPONDENT
_____________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB364; OR
CODED 2, 7, 8, OR 9 IN IB36B4.
001-100 = PERCENTAGE
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IBINS4 307-309 PERCENTAGE PAID BY INSURANCE COMPANY
____________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB364; OR
CODED 2, 7, 8, OR 9 IN IB36B4.
* 001-100 = PERCENTAGE
* 997 = REFUSED
* 998 = DK
* 999 = NOT ASCERTAINED
* SKIP IB36D4
(50)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36D4 310-315 HOW MUCH DO YOU PAY PER MENTAL HEALTH SERVICE?
_______________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB364; OR
CODED 1, 7, 8 OR 9 IN IB36B4.
000001-999996 = AMOUNT
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
IB36E4 316 IS THERE A LIFETIME MAXIMUM OR A YEARLY MAXIMUM THAT THE INSURANCE COMPANY WILL PAY?
_____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB364.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36DOL - IB36MAX
IB36AMT4 (317-323) HOW MUCH WAS PAID FOR MENTAL HEALTH SERVICES?
______________________________________________
IB36DOL 317-322 AMOUNT
______
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8, OR 9 IN IB364; OR
CODED 2, 7, 8 OR 9 IN IB36E4.
000001-999996 = AMOUNT
* 999991 = OTHER SPECIFIED
999996 = EQUAL TO 999996 OR GREATER
* 999997 = REFUSED
* 999998 = DK
* 999999 = NOT ASCERTAINED
* SKIP IB36MAX
(51)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36MAX 323 TYPE OF MAXIMUM PAID
____________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8, OR 9 IN IB364; OR
CODED 2, 7, 8 OR 9 IN IB36E4; OR CODED 91, 97, 98 OR 99 IN IB36DOL.
1 = LIFETIME MAXIMUM
2 = YEARLY MAXIMUM
3 = RESPONSE GIVEN IN VISITS-NOT IN DOLLARS
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB36F4 324 DOES THIS CHANGE AFTER YOU HAVE REACHED A SPECIFIED AMOUNT?
____________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8, OR 9 IN IB364; OR
CODED 2, 7, 8 OR 9 IN IB36E4; OR CODED 7, 8 OR 9 IN IB36MAX.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DON'T KNOW
* 9 = NOT ASCERTAINED
* SKIP IB36G4
IB36G4 325-328 HOW DOES IT CHANGE?
____________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8, OR 9 IN IB364; OR
CODED 2, 7, 8 OR 9 IN IB36F4
0001 = INSURANCE PAYS 100% AFTER SPECIFIED AMOUNT
0002 = LIFETIME LIMIT SPECIFIED
0003 = INSURANCE PAYS 100% UP TO LIFETIME MAXIMUM/YEARLY MAXIMUM
0004 = SPECIFIED TIME LIMIT OR NUMBER OF TIMES/THEN PATIENT MUST PAY
0005 = LIMIT GIVEN BUT NOT SPECIFIED IF YEARLY/LIFETIME
0006 = INSURANCE PAYS 80% UP TO LIMIT
0007 = INSURANCE PAYS UP TO USUAL AND CUSTOMARY PATIENT PAYS REST
0008 = YEARLY MAXIMUM SPECIFIED
0009 = INSURANCE PAYS 100% UP TO LIMIT
0010 = 90% OF USUAL AND CUSTOMARY
0011 = PREAPPROVED - 100%
0012 = INSURANCE PAYS 100% TO LIMIT THEN 80%
0013 = COPAY AMOUNT INCREASES AFTER SET AMOUNT OF VISITS/$ AMOUNT
9991 = OTHER SPECIFIED
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
(52)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB365 329 DOES YOUR INSURANCE PAY FOR A DENTAL CARE PROVIDER?
____________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36A5 - IB36G5
IB36A5 330 DO YOU HAVE A CO-PAYMENT, THAT IS, DO YOU HAVE TO PAY SOME OF THE COST OUT OF YOUR OWN
POCKET FOR DENTAL CARE?
________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB365.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IB36B5 331 IS THERE A PERCENTAGE APPLIED TO THIS BILL, FOR EXAMPLE, YOU WOULD PAY 20% AND THE
INSURANCE COMPANY PAYS 80%, OR DO YOU PAY A FLAT RATE PER INCIDENT?
____________________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB365.
1 = PERCENTAGE
* 2 = FLAT FEE
** 7 = REFUSED
** 8 = DK
** 9 = NOT ASCERTAINED
* SKIP IBR5 - IBINS5
** SKIP IBR5 - IB36D5
IB36C5 (332-337) PERCENTAGES PAID BY RESPONDENT AND INSURANCE COMPANY
____________________________________________________
(53)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IBR5 332-334 PERCENTAGE PAID BY RESPONDENT
_____________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB365; OR
CODED 2, 7, 8 OR 9 IN IB36B5.
001-100 = PERCENTAGE
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IBINS5 335-337 PERCENTAGE PAID BY INSURANCE COMPANY
____________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB365; OR
CODED 2, 7, 8 OR 9 IN IB36B5.
* 001-100 = PERCENTAGE
* 997 = REFUSED
* 998 = DK
* 999 = NOT ASCERTAINED
* SKIP IB36D5
IB36D5 338-343 HOW MUCH DO YOU PAY PER DENTAL VISIT?
______________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB365; OR
CODED 1, 7, 8 OR 9 IN IB36B5.
000001-999996 = AMOUNT
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
IB36F5 344 DOES THIS CHANGE AFTER YOU HAVE REACHED A SPECIFIED AMOUNT?
____________________________________________________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB365.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IB36G5
(54)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IB36G5 345-348 HOW DOES IT CHANGE?
____________________
+ = INAPPLICABLE, CODED 2 IN IBBOX10; OR CODED 2, 7, 8 OR 9 IN IB365; OR
CODED 2, 7, 8 OR 9 IN IB36F5.
0001 = INSURANCE PAYS 100% AFTER SPECIFIED AMOUNT
0002 = LIFETIME LIMIT SPECIFIED
0003 = INSURANCE PAYS 100% UP TO LIFETIME MAXIMUM/YEARLY MAXIMUM
0004 = SPECIFIED TIME LIMIT OR NUMBER OF TIMES/THEN PATIENT MUST PAY
0005 = LIMIT GIVEN BUT NOT SPECIFIED IF YEARLY/LIFETIME
0006 = INSURANCE PAYS 80% UP TO LIMIT
0007 = INSURANCE PAYS UP TO USUAL AND CUSTOMARY PATIENT PAYS REST
0008 = YEARLY MAXIMUM SPECIFIED
0009 = INSURANCE PAYS 100% UP TO LIMIT
0010 = 90% OF USUAL AND CUSTOMARY
0011 = PREAPPROVED - 100%
0012 = INSURANCE PAYS 100% TO LIMIT THEN 80%
0013 = COPAY AMOUNT INCREASES AFTER SET AMOUNT OF VISITS/$ AMOUNT
9991 = OTHER SPECIFIED
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
HLTHSTAT (349-380) HEALTH STATUS
_____________
IC15 (349-353) IN THE PAST 5 YEARS AND BEFORE AUGUST 31, 1992, DID YOU EVER HAVE ANY OF THE FOLLOWING
SYMPTOMS? CIRCLE ALL THAT APPLY
________________________________
IC15A 349 SWOLLEN GLANDS (LYMPH NODES)
____________________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
(55)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IC15B 350 PERSISTENT FEVER
________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC15C 351 DIARRHEA
________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC15D 352 WEIGHT LOSS ( NOT INTENTIONAL )
_______________________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC15E 353 NONE
____
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16 (354-371) IN THE PAST 5 YEARS AND BEFORE AUGUST 31, 1992,DID YOU EVER HAVE A DOCTOR TELL YOU THAT
YOU HAD ANY OF THE FOLLOWING DISEASES OR CONDITIONS? CIRCLE ALL THAT APPLY.
_____________________________________________________________________________
(56)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IC16A 354 CANDIDIASIS (THRUSH)
____________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16B 355 PCP (PNEUMOCYSTIS CARINII PNEUMONIA)
____________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16C 356 KAPOSI'S SARCOMA (KS)
_____________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16D 357 LYMPHOMA
________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16E 358 WASTING SYNDROME
________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
(57)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IC16F 359 TB ( TUBERCULOSIS )
___________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16G 360 CRYPTOCOCCOSIS
______________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16H 361 CMV ( CYTOMEGALOVIRUS )
_______________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16I 362 MAI
___
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16J 363 CRYPTOSPORIDIOSIS
_________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
(58)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IC16K 364 DEMENTIA
________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16L 365 HERPES SIMPLEX CAUSING SORES FOR A MONTH OR MORE IN THE MOUTH OR THROUGHOUT THE BODY
____________________________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16M 366 HISTOPLASMOSIS
______________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16N 367 TOXOPLASMOSIS ( TOXO )
______________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16O 368 ISOSPORIASIS
____________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
(59)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IC16P 369 LEUKOENCEPHALOPATHY
___________________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16Q 370 SALMONELLOSIS
_____________
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC16R 371 NONE
____
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC17 372 BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID YOU HAVE A T4 TEST?
__________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DON'T KNOW
* 9 = NOT ASCERTAINED
* SKIP IC18 - IC20
(60)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IC18 373 WHAT WAS YOUR MOST RECENT T4 COUNT DURING THIS PERIOD? WAS IT: PROBE: YOUR CD4 COUNT?
_________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2 OR 7 OR 8 OR 9 IN IC17.
1 = 0 - 100
2 = 101 - 200
3 = 201 - 300
4 = 301 - 500
5 = GREATER THAN 500
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IC19 (374-379) WHAT WAS THE DATE OF YOUR RECENT T4 TEST DURING THIS PERIOD?
CODER: IF IC19YR EQUALS 97, 98 OR 99, CODE 99 IN IC19MO AND IC19DY.
IC19MO 374-375 MONTH
_____
+ = INAPPLICABLE, CODED 2 OR 7 OR 8 OR 9 IN IC17.
01-12 = MONTH
97 = REFUSED
98 = DON'T KNOW
99 = NOT ASCERTAINED
IC19DY 376-377 DAY
___
+ = INAPPLICABLE, CODED 2 OR 7 OR 8 OR 9 IN IC17.
01-31 = DAY
97 = REFUSED
98 = DON'T KNOW
99 = NOT ASCERTAINED
IC19YR 378-379 YEAR
____
+ = INAPPLICABLE, CODED 2 OR 7 OR 8 OR 9 IN IC17.
92 = YEAR
97 = REFUSED
98 = DON'T KNOW
99 = NOT ASCERTAINED
(61)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IC20 380 BETWEEN (REF. DATE) AND AUGUST 31, 1992, WAS YOUR T4 COUNT EVER LESS THAN 200?
________________________________________________________________________________
+ = INAPPLICABLE, CODED 2 OR 7 OR 8 OR 9 IN IC17.
1 = YES
2 = NO
7 = REFUSED
8 = DON'T KNOW
9 = NOT ASCERTAINED
IIPSTAYS (381-385) INPATIENT HOSPITAL STAYS
________________________
ID1A 381 YOU TOLD ME YOU WERE HOSPITALIZED AT LEAST ONCE BETWEEN (REF. DATE) AND AUGUST 31, 1992.
HOW MANY TIMES WERE YOU IN THE HOSPITAL OVERNIGHT OR LONGER BETWEEN (REF. DATE) AND
AUGUST 31, 1992?
_________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP ID1B
ID1B 382-383 HOW MANY TIMES HAVE YOU BEEN IN THE HOSPITAL OVERNIGHT OR LONGER BETWEEN (REF. DATE) AND
AUGUST 31, 1992?
_________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN ID1A.
01-96 = NUMBER OF TIMES
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
ID06CT 384-385 NUMBER OF INPATIENT STAY RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
INURSHOM (386-390) NURSING HOME/RESIDENTIAL CARE STAYS
___________________________________
(62)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IE1A 386 HAVE YOU BEEN A PATIENT IN A RESIDENTIAL CARE FACILITY, A NURSING HOME OR HOSPICE
OVERNIGHT OR LONGER?
_____________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IE1B
IE1B 387-388 HOW MANY TIMES HAVE YOU BEEN IN A RESIDENTIAL CARE FACILITY, NURSING HOME OR HOSPICE
OVERNIGHT OR LONGER BETWEEN (REF. DATE) AND AUGUST 31, 1992?
______________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IE1A.
01-96 = NUMBER OF TIMES
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IE08CT 389-390 NUMBER OF NURSING HOME/RESIDENTIAL CARE RECORDS
_______________________________________________
00 = NONE LISTED
01-99 = NUMBER
IMEDVIST (391-410) MEDICAL VISITS
______________
IF1 391 BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID YOU GO TO A HOSPITAL EMERGENCY ROOM FOR
MEDICAL CARE? INCLUDE ANY VISITS TO THE EMERGENCY ROOM, (EVEN IF YOU WERE ADMITTED TO
THE HOSPITAL FROM THERE).
__________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IF1A
(63)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IF1A 392-393 HOW MANY DIFFERENT EMERGENCY ROOMS DID YOU VISIT BETWEEN (REF. DATE) AUGUST 31, 1992?
_______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IF1.
01-96 = NUMBER OF EMERGENCY ROOMS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IF10CT 394-395 NUMBER OF EMERGENCY ROOM RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
IF2 396 DID YOU GO TO A HOSPITAL CLINIC OR HOSPITAL OUT-PATIENT DEPARTMENT FOR MEDICAL CARE?
THESE VISITS COULD INCLUDE AN AEROSOL PENTAMIDINE CLINIC, AN EYE CLINIC, A LABORATORY
WHERE THEY MIGHT CONDUCT BLOOD TESTS, OR A THERAPIST WHO WORKS IN A HOSPITAL.
______________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IF2A
IF2A 397-398 HOW MANY DIFFERENT HOSPITAL CLINICS AND-OR HOSPITAL OUT-PATIENT DEPARTMENTS DID YOU VISIT
SINCE BETWEEN (REF. DATE) AND AUGUST 31, 1992?
________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IF2.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IF11CT 399-400 NUMBER OF HOSPITAL CLINIC RECORDS
_________________________________
00 = NONE LISTED
01-99 = NUMBER
(64)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IF3 401 HAVE YOU BEEN TO ANY OTHER MEDICAL CLINIC, FOR EXAMPLE, A COMMUNITY CLINIC OR A
NEIGHBOURHOOD HEALTH CENTER? THESE VISITS COULD INCLUDE BLOOD TESTS, OR OTHER LAB WORK,
OR SCANS LIKE MRI'S OR X-RAY PROCEDURES.
_________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IF3A
IF3A 402-403 HOW MANY DIFFERENT MEDICAL CLINICS DID YOU VISIT BETWEEN (REF. DATE) AND AUGUST 31,
1992?
______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IF3.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IF12CT 404-405 NUMBER OF MEDICAL CLINIC RECORDS
________________________________
00 = NONE LISTED
01-99 = NUMBER
IF4 406 HAVE YOU BEEN TO A PRIVATE DOCTOR'S OFFICE FOR MEDICAL CARE? THESE VISITS COULD ALSO
INCLUDE BLOOD TESTS, OTHER LAB WORK, OR SCANS LIKE MRI'S OR X-RAY PROCEDURES.
______________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IF4A
IF4A 407-408 HOW MANY DIFFERENT PRIVATE DOCTOR'S OFFICES DID YOU VISIT BETWEEN (REF. DATE) AND AUGUST
31, 1992?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IF4.
01-96 = NUMBER OF PROVIDERS
(65)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IF13CT 409-410 NUMBER OF PRIVATE DOCTOR'S OFFICE RECORDS
_________________________________________
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
00 = NONE LISTED
01-99 = NUMBER
IOTHPROV (411-428) OTHER HEALTH CARE PROVIDERS
___________________________
IG1 411 BETWEEN (REF. DATE) AND AUGUST 31, 1992, HAVE YOU ATTENDED A SUPPORT GROUP, OR RECEIVED
ANY PSYCHOLOGICAL COUNSELING OR THERAPY? PLEASE DO NOT INCLUDE TREATMENT RECEIVED FOR
PROBLEMS RELATED TO DRUG OR ALCOHOL USE.
_________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IG1A
IG1A 412-413 HOW MANY DIFFERENT SUPPORT GROUPS OR PSYCHOLOGICAL COUNSELORS DID YOU VISIT BETWEEN (REF.
DATE) AND AUGUST 31, 1992?
___________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IG1.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IG14CT 414-415 NUMBER OF MENTAL HEALTH PROVIDER RECORDS
________________________________________
00 = NONE LISTED
01-99 = NUMBER
(66)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IG2 416 HAVE YOU RECEIVED CARE FROM ANY MEDICAL PRACTITIONERS SUCH AS OPTOMETRISTS, FOOT DOCTORS,
OR CHIROPRACTORS?
__________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IG2A
IG2A 417-418 YOU TOLD ME YOU USED THE SERVICES OF A (MEDICAL PRACTITIONER). HOW MANY DIFFERENT
(MEDICAL PRACTITIONERS) DID YOU VISIT BETWEEN (REF. DATE) AND AUGUST 31, 1992?
________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IG2.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IG15CT 419-420 NUMBER OF MEDICAL PRACTITIONER RECORDS
______________________________________
00 = NONE LISTED
01-99 = NUMBER
IG3 421 HAVE YOU RECEIVED TREATMENT FROM ANY ALTERNATIVE THERAPIST, A PRACTITIONER OF HOLISTIC
MEDICINE, A NUTRITIONIST, OR ANY OTHER ALTERNATIVE THERAPY LIKE BIOFEEDBACK?
_____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IG3A
(67)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IG3A 422-423 YOU TOLD ME YOU USED THE SERVICES OF A (ALTERNATIVE THERAPIST). HOW MANY DIFFERENT
(ALTERNATIVE THERAPISTS) DID YOU VISIT BETWEEN (REF. DATE) AND AUGUST 31, 1992?
_________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IG3.
01-96 = NUMBER OF PROVIDERS
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IG16CT 424-425 NUMBER OF ALTERNATIVE THERAPIST RECORDS
_______________________________________
00 = NONE LISTED
01-99 = NUMBER
IG4 426 BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID YOU BUY OR REPLACE ANY SPECIAL MEDICAL
EQUIPMENT LIKE EYEGLASSES, A CANE OR A NEBULIZER?
__________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IG17CT 427-428 NUMBER OF MEDICAL EQUIPMENT PROVIDER RECORDS
____________________________________________
00 = NONE LISTED
01-99 = NUMBER
IHOMHLTH (429-432) HOME HEALTH CARE
________________
(68)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IH1 429 SOMETIMES WHEN PEOPLE ARE ILL, THEY NEED TO RECEIVE HELP AT HOME. THIS HELP COULD BE FOR
MEDICAL PROBLEMS, FOR HELP WITH PERSONAL CARE OR HOUSEKEEPING, OR FOR OTHER SERVICES THEY
MIGHT NEED. PLEASE LOOK AT THIS CARD. SINCE (REF. DATE), HAVE YOU RECEIVED ANY OF
THESE KINDS OF SERVICES AT HOME? (CIRCLE THE PROVIDER TYPE IN COLUMN A.)
_________________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IH2 430 HAVE YOU RECEIVED HELP AT HOME BY ANY OTHER PEOPLE NOT SHOWN ON THE CARD? (SPECIFY THE
PROVIDER TYPE IN COLUMN A.)
___________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IH19CT 431-432 NUMBER OF HOME HEALTH CARE PROVIDER RECORDS
___________________________________________
00 = NONE LISTED
01-99 = NUMBER
I_NONMED (433-453) NON - MEDICAL SERVICES
______________________
II1 433 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE
(REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH FINDING
OR KEEPING A PLACE TO LIVE?
____________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(69)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
II21CT 434-435 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH HOUSING
____________________________________________________
00 = NONE
01-99 = NUMBER
II2 436 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE
(REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH LEGAL
SERVICES?
__________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
II22CT 437-438 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH LEGAL SERVICES
___________________________________________________________
00 = NONE
01-99 = NUMBER
II3 439 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE
(REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH CHILD
CARE?
______
1 = YES
2 = NO
3 = NO CHILDREN
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
II23CT 440-441 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH CHILD CARE
_______________________________________________________
00 = NONE
01-99 = NUMBER
(70)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
II4 442 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE
(REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
TRANSPORTATION?
________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
II24CT 443-444 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH TRANSPORTATION
___________________________________________________________
00 = NONE
01-99 = NUMBER
II5 445 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE
(REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
OBTAINING FOOD, EITHER GROCERIES YOU WERE GIVEN OR MEALS YOU WERE SERVED OUTSIDE YOUR
HOME?
______
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
II25CT 446-447 NUMBER OF RECORDS FOR PROVIDERS HELPING OBTAIN FOOD
___________________________________________________
00 = NONE
01-99 = NUMBER
II6 448 PEOPLE WITH HIV INFECTION OFTEN NEED HELP WITH OTHER TYPES OF SERVICES AS WELL. SINCE
(REF. DATE), HAVE YOU RECEIVED HELP FROM ANY AGENCY, GROUP OR ORGANIZATION WITH
FINANCIAL ASSISTANCE?
______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(71)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
II26CT 449-450 NUMBER OF RECORDS FOR PROVIDERS HELPING WITH FINANCIAL ASSISTANCE
_________________________________________________________________
00 = NONE
01-99 = NUMBER
II7 451 ARE YOU CURRENTLY RECEIVING TREATMENT OR COUNSELING FOR PROBLEMS RELATED TO ALCOHOL OR
DRUG USE?
__________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
II27CT 452-453 NUMBER OF RECORDS FOR ALCOHOL/DRUG TREATMENT PROVIDERS
______________________________________________________
00 = NONE
01-99 = NUMBER
IDNTLSRV (454-458) DENTAL SERVICES
_______________
IJ1 454 BETWEEN (REF. DATE) AND AUGUST 31, 1992 HAVE YOU SEEN A DENTIST, ORAL SURGEON, OR OTHER
PROFESSIONAL DENTAL CARE PROVIDER?
___________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IJ1A
(72)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IJ1A 455-456 BETWEEN (REF. DATE) AND AUGUST 31, 1992, HOW MANY TIMES HAVE YOU SEEN A DENTIST, ORAL
SURGEON, OR OTHER PROFESSIONAL DENTAL CARE PROVIDER?
_____________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IJ1.
01-96 = NUMBER
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IJ29CT 457-458 NUMBER OF DENTAL VISIT RECORDS
______________________________
00 = NONE
01-99 = NUMBER
IWMNHLTH (459-486) WOMEN'S HEALTH CARE
___________________
IKSEX 459 SEX OF PATIENT (MALE OR FEMALE)
_______________________________
* 1 = MALE
2 = FEMALE
* SKIP IK1A - IK7
IK1 (460-466) BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID A DOCTOR EVER TELL YOU THAT YOU HAD....
______________________________________________________________________________________
IK1A 460 A SEXUALLY TRANSMITTED DISEASE, AN STD, LIKE SYPHILIS, CHANCROID OR GONORRHEA?
_______________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(73)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IK1B 461 CHRONIC VAGINITIS?
___________________
+ = INAPPLICABLE, CODED 1 IN IKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK1C 462 PID, PELVIC INFLAMMATORY DISEASE?
__________________________________
+ = INAPPLICABLE, CODED 1 IN IKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK1D 463 HERPES SIMPLEX
______________
+ = INAPPLICABLE, CODED 1 IN IKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK1E 464 VAGINAL CANDIDIASIS OR A "YEAST INFECTION"?
____________________________________________
+ = INAPPLICABLE, CODED 1 IN IKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(74)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IK1F 465 HPV, HUMAN PAPILLOMAVIRUS?
___________________________
+ = INAPPLICABLE, CODED 1 IN IKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK1G 466 AN ABNORMAL PAP TEST
____________________
+ = INAPPLICABLE, CODED 1 IN IKSEX.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK2 467 BETWEEN (REF. DATE) AND AUGUST 31, 1992, WERE YOU PREGNANT?
_____________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IKSEX.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IK3 - IK7
IK3 468 DID YOU RECIEVE PRENATAL CARE?
_______________________________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2 OR 7 OR 8 OR 9 IN IK2.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IK4PROV - IK6
(75)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IK4PROV 469-475 PROVIDER ID
___________
+ = INAPPLICABLE, CODED 1 IN IKSEX; OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3.
0000001-
9999996 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
9999997 = REFUSED
9999998 = DK
9999999 = NOT ASCERTAINED
IK5 (476-483) HOW IS THIS CARE PAID FOR?
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).
IK5A 476 MEDICAID
________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK5B 477 OTHER PUBLIC ASSISTANCE
_______________________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(76)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IK5C 478 PRIVATE INSURANCE
_________________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK5D 479 MEDICARE
________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK5E 480 SELF PAY
________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3.
1 = CIRCLED
2 = NOT CIRCLED
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK5F 481 OTHER
_____
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3.
1 = CIRCLED
* 2 = NOT CIRCLED
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IK5FOS
(77)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IK5FOS 482-483 OTHER SPECIFIED
_______________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3; OR CODED 2, 7, 8 OR 9 IN IK5F.
01 = RESEARCH STUDY/GRANT
03 = FLAT FEE
05 = GAY AIDS TASK FORCE/AIDS NETWORK
14 = FAMILY/FRIEND
29 = COMMUNITY HEALTH PROJECT
46 = PROVIDER
47 = PRIVATE CHARITY/GRANT FROM AIDS FOUNDATION
50 = DRUG COMPANY
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IK6 484 DURING YOUR PRENATAL CARE ARE YOU BEING GIVEN ANY SPECIAL COUNSELING RELATING TO YOUR HIV
INFECTION?
___________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2; OR CODED 2,
7, 8 OR 9 IN IK3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IK7 485-486 WHAT KINDS OF PROBLEMS DID YOU FACE IN RECEIVING PRE-NATAL CARE? RECORD VERBATIM.
___________________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IKSEX, OR CODED 2, 7, 8 OR 9 IN IK2.
01 = NO PROBLEMS
02 = DIDN'T WANT TO GO FOR CARE
03 = NONE BECAUSE TERMINATED PREGNANCY OR ABORTION
04 = HAD MISCARRIAGE
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IDRGSECT (491-571) HIV - RELATED MEDICINES
_______________________
(78)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IL1 487 BETWEEN (REF. DATE) AND AUGUST 31, 1992, HAVE YOU TAKEN ANY OF THE MEDICINES OR DRUGS
LISTED ON THIS CARD? RECORD NAMES IN COLUMN A
______________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IL2 488 BETWEEN (REF. DATE) AND AUGUST 31, 1992 DID YOU TAKE ANY OTHER PRESCRIPTION MEDICINES OR
DRUGS? IF YES TO L-1 OR L-2, RECORD NAMES IN COLUMN A. IF NAME IS UNKNOWN, PROBE FOR
CONDITION AND RECORD IN COLUMN A. IF MEDICINE NAME OR CONDITION IS UNKNOWN, PROBE FOR
DRUG PROVIDER NAME AND ADDRESS. ASK B THROUGH G FOR EACH DRUG LISTED BEFORE MOVING TO
NEXT DRUG.
___________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IL32CT 489-490 NUMBER OF PRESCRIPTION DRUG RECORDS
___________________________________
00 = NONE LISTED
01-99 = NUMBER
IL3 491 BETWEEN (REF. DATE) AND AUGUST 31, 1992 DID YOU TAKE ANY NON-PRESCRIPTION MEDICINES OR
DRUGS OR ANY OTHER NON-TRADITIONAL SUBSTANCES TO HELP DEAL WITH HIV/AIDS RELATED ILLNESS?
__________________________________________________________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IL4CT 492-493 NUMBER OF NON-PRESCRIPTION DRUGS/NON-TRADITIONAL SUBSTANCES LISTED IN Q L-4
___________________________________________________________________________
* 00 = NO DRUGS LISTED
01-99 = NUMBER OF DRUGS LISTED
* SKIP IL4A - IL5
(79)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IL4 (494-565) WHAT ARE THE NAMES OF THE NON-PRESCRIPTION DRUGS OR NON-TRADITIONAL SUBSTANCES THAT YOU
ARE TAKING?
____________
IL4A 494-496 NON - PRESCRIPTION DRUG 1
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4B 497-499 NON - PRESCRIPTION DRUG 2
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4C 500-502 NON - PRESCRIPTION DRUG 3
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4D 503-505 NON - PRESCRIPTION DRUG 4
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(80)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IL4E 506-508 NON - PRESCRIPTION DRUG 5
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4F 509-511 NON - PRESCRIPTION DRUG 6
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4G 512-514 NON - PRESCRIPTION DRUG 7
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4H 515-517 NON - PRESCRIPTION DRUG 8
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(81)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IL4I 518-520 NON - PRESCRIPTION DRUG 9
_________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4J 521-523 NON - PRESCRIPTION DRUG 11
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4K 524-526 NON - PRESCRIPTION DRUG 11
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4L 527-529 NON - PRESCRIPTION DRUG 12
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(82)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IL4M 530-532 NON - PRESCRIPTION DRUG 13
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4N 533-535 NON - PRESCRIPTION DRUG 15
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4O 536-538 NON - PRESCRIPTION DRUG 16
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT, OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4P 539-541 NON - PRESCRIPTION DRUG 16
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(83)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IL4Q 542-544 NON - PRESCRIPTION DRUG 17
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4R 545-547 NON - PRESCRIPTION DRUG 18
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4S 548-550 NON - PRESCRIPTION DRUG 19
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4T 551-553 NON - PRESCRIPTION DRUG 20
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(84)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IL4U 554-556 NON - PRESCRIPTION DRUG 21
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4V 557-559 NON - PRESCRIPTION DRUG 22
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4W 560-562 NON - PRESCRIPTION DRUG 23
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IL4X 563-565 NON - PRESCRIPTION DRUG 24
__________________________
+ = INAPPLICABLE, CODED 00 IN IL4CT; OR NO OTHER NON-PRESCRIPTION
DRUG/SUBSTANCE LISTED.
001-720 = USE CODES IN APPENDIX 28
991 = OTHER SPECIFIED
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
(85)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IL5 566-571 WE'RE INTERESTED IN THE TOTAL AMOUNT YOU SPENT ON (MEDICINE). HOW MUCH DID YOU PAY FOR
(MEDICINES IN Q L-5) BETWEEN (REF. DATE) AND AUGUST 31, 1992?
CODER: CODE AMOUNTS IN WHOLE DOLLARS.
+ = INAPPLICABLE, CODED 00 IN IL4CT.
000000 = NOTHING
000001-999996 = AMOUNT
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
IFUNCTN (572-607) FUNCTIONAL STATUS
_________________
IM1 572 IN GENERAL, WOULD YOU SAY THAT YOUR HEALTH IS EXCELLENT, VERY GOOD, GOOD, FAIR, OR POOR?
_________________________________________________________________________________________
1 = EXCELLENT
2 = VERY GOOD
3 = GOOD
4 = FAIR
5 = POOR
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2 (573-588) I AM GOING TO READ YOU SOME PROBLEMS PEOPLE CAN HAVE IN THEIR DAILY LIVES. THINKING
ABOUT YOUR LIFE SINCE (REF. DATE), PLEASE TELL ME WHETHER THESE PROBLEMS HAVE BEEN TRUE
FOR YOU MOST OF THE TIME. (READ ITEMS A-P). HAS THAT BEEN TRUE FOR YOU MOST OF THE
TIME?
______
IM2A 573 I HAVE PAIN AT NIGHT
____________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(86)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IM2B 574 I TAKE TABLETS TO HELP ME SLEEP
_______________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2C 575 I HAVE UNBEARABLE PAIN
______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2D 576 I AM TIRED ALL THE TIME
_______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2E 577 I FIND IT PAINFUL TO CHANGE POSITION
____________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2F 578 I'M IN PAIN WHEN I WALK
_______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(87)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IM2G 579 I'M WAKING UP IN THE EARLY HOURS OF THE MORNING
_______________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2H 580 EVERYTHING IS AN EFFORT
_______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2I 581 I LIE AWAKE FOR MOST OF THE NIGHT
_________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2J 582 I'M IN PAIN WHEN I'M STANDING
_____________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2K 583 IT TAKES ME A LONG TIME TO GET TO SLEEP
_______________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(88)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IM2L 584 I SOON RUN OUT OF ENERGY
________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2M 585 I'M IN CONSTANT PAIN
____________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2N 586 I'M IN PAIN WHEN GOING UP AND DOWN STAIRS
_________________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2O 587 I SLEEP BADLY AT NIGHT
______________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM2P 588 I'M IN PAIN WHEN I'M SITTING
____________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(89)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IM3 (589-594) I'M GOING TO READ YOU A LIST OF ACTIVITIES. PLEASE TELL ME HOW LONG, IF AT ALL, YOUR
HEALTH HAS LIMITED YOU IN EACH ACTIVITY. (READ ITEM) HAS YOUR HEALTH LIMITED YOU FOR
MORE THAN 3 MONTHS, LESS THAN 3 MONTHS, OR NOT LIMITED YOU AT ALL.
___________________________________________________________________
IM3A 589 THE KINDS OR AMOUNTS OF VIGOROUS ACTIVITIES YOU CAN DO, LIKE LIFTING HEAVY OBJECTS,
RUNNING OR PARTICIPATING IN STRENUOUS SPORTS
____________________________________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM3B 590 THE KINDS OR AMOUNTS OF MODERATE ACTIVITIES YOU CAN DO LIKE MOVING A TABLE, CARRYING
GROCERIES OR BOWLING
____________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM3C 591 WALKING UPHILL OR CLIMBING A FEW FLIGHTS OF STAIRS
__________________________________________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM3D 592 BENDING, LIFTING, OR STOOPING
_____________________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(90)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IM3E 593 WALKING ONE BLOCK
_________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM3F 594 EATING, DRESSING, BATHING OR USING THE TOILET
_____________________________________________
1 = LIMITED FOR MORE THAN 3 MONTHS
2 = LIMITED FOR 3 MONTHS OR LESS
3 = NOT LIMITED AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM4 595 SINCE (REF. DATE) HAS YOUR HEALTH KEPT YOU FROM WORKING AT A JOB, DOING WORK AROUND THE
HOUSE, OR GOING TO SCHOOL.
___________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IM5
IM5 596 DID YOUR HEALTH ALSO KEEP YOU FROM DOING THESE KINDS OF ACTIVITIES BEFORE (REF. DATE)?
________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IM4.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(91)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IM6 597 SINCE (REF. DATE) HAVE YOU BEEN UNABLE TO DO CERTAIN KINDS OR AMOUNTS OF WORK,
HOUSEWORK, OR SCHOOLWORK BECAUSE OF YOUR HEALTH?
_________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IM7
IM7 598 WERE YOU ALSO UNABLE TO DO THESE KINDS OF ACTIVITIES BECAUSE OF HEALTH BEFORE (REF.
DATE)?
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IM6.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM8 599 IN THE PAST MONTH, HOW OFTEN HAVE YOU SPENT TIME WITH OR TALKED TO RELATIVES OR FRIENDS
-- DAILY, SEVERAL TIMES A WEEK, SEVERAL TIMES A MONTH, ONCE OR TWICE, OR NOT AT ALL?
(CIRCLE ONE ONLY)
_________________
1 = DAILY
2 = SEVERAL TIMES A WEEK
3 = SEVERAL TIMES A MONTH (WEEKLY)
4 = ONCE OR TWICE
5 = NOT AT ALL
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(92)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IM9 600 DURING THE PAST MONTH, HOW MUCH OF THE TIME HAS YOUR HEALTH LIMITED YOUR SOCIAL
ACTIVITIES LIKE VISITING WITH FRIENDS OR RELATIVES? PLEASE LOOK AT THIS CARD AND TELL ME
THAT ANSWER THAT SHOWS HOW MUCH OF THE TIME YOU HAVE BEEN LIMITED.
___________________________________________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM10 (601-605) PLEASE LOOK AT THIS CARD AGAIN AND TELL ME THE ANSWER THAT COMES CLOSEST TO THE WAY
YOU'VE BEEN FEELING. DURING THE PAST MONTH, HOW MUCH OF THE TIME:
___________________________________________________________________
IM10A 601 HAVE YOU BEEN A VERY NERVOUS PERSON?
_____________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM10B 602 HAVE YOU FELT CALM AND PEACEFUL?
_________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(93)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IM10C 603 HAVE YOU FELT DOWNHEARTED AND BLUE?
____________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM10D 604 HAVE YOU BEEN A HAPPY PERSON?
______________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM10E 605 HAVE YOU FELT SO DOWN IN THE DUMPS THAT NOTHING COULD CHEER YOU UP?
____________________________________________________________________
1 = ALL OF THE TIME
2 = MOST OF THE TIME
3 = A GOOD BIT OF THE TIME
4 = SOME OF THE TIME
5 = A LITTLE OF THE TIME
6 = NONE OF THE TIME
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IM11 606-607 LOOK AT THE FLAP. (NOT INCLUDING YOUR SPOUSE/PARTNER), HOW MANY FAMILY MEMBERS OR
FRIENDS, IF ANY, CAN YOU CONFIDE IN AND TALK TO ABOUT PERSONAL FEELINGS AND PROBLEMS?
______________________________________________________________________________________
00 = NONE
01-20 = NUMBER
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(94)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
ICAREACS (0001) ACCESS AND BARRIERS TO CARE
___________________________
IN1 608 IS THERE A PARTICULAR CLINIC, HEALTH CENTER, DOCTOR'S OFFICE, OR OTHER PLACE THAT YOU
USUALLY GO FOR MEDICAL CARE OR ADVICE ABOUT YOUR HEALTH?
_________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN2A - IN8YRS
IN2 (609-617) WHAT KIND OF PLACE IS THAT - A CLINIC, A HOSPITAL, A DOCTOR'S OFFICE, OR SOME OTHER
PLACE? (CODE ONLY ONE.) PLEASE GIVE ME THE NAME OF THAT PLACE.
________________________________________________________________
IN2A 609-610 PROVIDER TYPE
_____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1.
01 = CLINIC
02 = HOSPITAL
03 = DOCTOR'S OFFICE
91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IN2PROV
IN2PROV 611-617 PROVIDER ID
___________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1; OR CODED 97, 98 OR 99 IN IN2A.
0000001-
9999996 = RANDOMLY ASSIGNED SEQUENTIAL NUMBER
9999997 = REFUSED
9999998 = DK
9999999 = NOT ASCERTAINED
(95)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN3 618 IS THERE A PARTICULAR DOCTOR THAT YOU USUALLY SEE AT (PLACE IN N2)?
____________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN4 619 DOES (PLACE IN N2) HAVE SOMEONE WHO HELPS YOU FILL OUT FORMS FOR MEDICARE, HEALTH
INSURANCE, OR PUBLIC ASSISTANCE PROGRAMS SUCH AS (MEDICAID OR STATE NAME FOR MEDICAID)?
________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN5 620-621 HOW DO YOU USUALLY GET THERE - BY WALKING, DRIVING, BEING DRIVEN BY SOMEONE ELSE, BY
TAXI, OTHER PUBLIC TRANSPORTATION, OR SOME OTHER WAY? CODE ONLY ONE.
______________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1.
01 = WALKING
02 = DRIVING
03 = BEING DRIVEN
04 = TAXI
05 = OTHER PUBLIC TRANSPORTATION
06 = AMBULETTE/AMBULANCE/OTHER MEDICAL TRANSPORTATION
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IN6 (622-626) ABOUT HOW LONG DOES IT USUALLY TAKE YOU TO GET THERE?
______________________________________________________
(96)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN6MIN 622-624 MINUTES
_______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1; OR CODED IN IN6HRS.
* 001-120 = NUMBER
* 997 = REFUSED
* 998 = DK
* 999 = NOT ASCERTAINED
* SKIP IN6HRS
IN6HRS 625-626 HOURS
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1; OR CODED IN IN6MIN.
01-05 = NUMBER
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IN7 627 WHEN YOU GO THERE, DO YOU USUALLY HAVE AN APPOINTMENT AHEAD OF TIME, DO YOU JUST WALK IN,
OR DO YOU SOMETIMES HAVE AN APPOINTMENT AND SOMETIMES NOT?
___________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1.
1 = HAS APPOINTMENT
2 = JUST WALKS IN
3 = SOMETIMES HAS APPOINTMENT
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN8 (628-631) HOW LONG HAVE YOU BEEN GOING TO (PLACE IN N2)?
_______________________________________________
IN8MOS 628-629 MONTHS
______
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1; OR CODED IN IN8YRS.
* 01-24 = NUMBER
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IN8YRS
(97)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN8YRS 630-631 YEARS
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN1; OR CODED IN IN8MOS.
01-05 = NUMBER
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IN9 (632-711) THERE ARE MANY HEALTH CARE SERVICES THAT PEOPLE NEED WHICH THEY SOMETIMES DO NOT RECEIVE.
LOOK AT THIS CARD AND PLEASE TELL ME IF YOU FELT YOU NEEDED ANY OF THESE SERVICES BETWEEN
(REF. DATE) AND AUGUST 31,1992 BUT FOR SOME REASON, YOU DID NOT RECEIVE THEM. CODE ALL
THAT APPLY IN COLUMN A. THEN ASK B-G FOR EACH SERVICE CODED.
______________________________________________________________
IN9AA 632 YOU FELT THAT YOU NEEDED EMERGENCY CARE, BUT DID NOT RECEIVE IT?
_________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9AB - IN9AG
IN9AB 633 YOU FELT THAT YOU NEEDED EMERGENCY CARE. DO YOU KNOW WHERE YOU CAN CAN GO TO GET
EMERGENCY CARE?
________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9AA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(98)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9AC 634 (IF YOU KNEW WHERE TO GO) DO YOU HAVE INSURANCE THAT WOULD PAY FOR EMERGENCY CARE?
___________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9AA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IN9AD
IN9AD 635 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR EMERGENCY CARE YOURSELF?
_______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9AA, OR CODED 1 IN IN9AC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9AE 636 (IF YOU KNEW WHERE TO GO) WOULD YOU HAVE TRANSPORTATION TO GET TO AN EMERGENCY CARE
PROVIDER?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9AA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9AF 637 BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID ANYONE REFUSE TO PROVIDE EMERGENCY CARE TO
YOU?
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9AA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9AG
(99)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9AG 638-641 WHY WERE YOU REFUSED EMERGENCY CARE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9AA, OR CODED 2, 7, 8 OR 9 IN
IN9AF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE, WAITING LIST, ETC
0003 = VARIETY OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER
0004 = RESPONDENT WAS TOLD; NOT SICK ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9991 = OTHER SPECIFIED
9992 = RESPONDENT DOES NOT ANSWER THE QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IN9BA 642 YOU FELT THAT YOU NEEDED AN OVERNIGHT HOSPITAL STAY, BUT DID NOT RECEIVE IT?
_____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9BB - IN9BG
IN9BB 643 YOU FELT THAT YOU NEEDED AN OVERNIGHT STAY. DID YOU KNOW WHERE YOU CAN GO TO GET AN
OVERNIGHT STAY?
________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9BA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(100)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9BC 644 (IF YOU KNEW WHERE TO GO) DID YOU HAVE INSURANCE THAT WOULD PAY FOR AN OVERNIGHT STAY?
_______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9BA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IN9BD
IN9BD 645 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR AN OVERNIGHT STAY YOURSELF?
__________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9BA, OR CODED 1 IN IN9BC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9BE 646 (IF YOU KNEW WHERE TO GO) DID YOU HAVE TRANSPORTATION TO GET TO AN OVERNIGHT STAY?
___________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9BA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9BF 647 BETWEEN (REF. DATE) AUGUST 31, 1992, DID ANYONE REFUSE TO PROVIDE AN OVERNIGHT STAY TO
YOU?
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9BA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9BG
(101)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9BG 648-651 WHY WERE YOU REFUSED AN OVERNIGHT STAY? RECORD VERBATIM.
__________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9BA, OR CODED 2, 7, 8 OR 9 IN
IN9BF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE, WAITING LIST, ETC
0003 = VARIETY OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER
0004 = RESPONDENT WAS TOLD; NOT SICK ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9991 = OTHER SPECIFIED
9992 = RESPONDENT DOES NOT ANSWER THE QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IN9CA 652 YOU FELT THAT YOU NEEDED HOME SERVICES, BUT DID NOT RECEIVE THEM?
__________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9CB - IN9CG
IN9CB 653 YOU FELT THAT YOU NEEDED HOME SERVICES. DID YOU KNOW WHERE YOU CAN GO TO GET HOME
SERVICES?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9CA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(102)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9CC 654 (IF YOU KNEW WHERE TO GO) DID YOU HAVE INSURANCE THAT WOULD PAY FOR HOME SERVICES?
___________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9CA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IN9CD
IN9CD 655 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR HOME SERVICES YOURSELF?
______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9CA, OR CODED 1 IN IN9CC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9CF 656 BETWEEN (REF. DATE) AND AUGUST 31, 1992 DID ANYONE REFUSE TO PROVIDE HOME SERVICES TO
YOU?
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9CA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9CG
(103)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9CG 657-660 WHY WERE YOU REFUSED HOME SERVICES? RECORD VERBATIM.
______________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9CA, OR CODED 2, 7, 8 OR 9 IN
IN9CF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE, WAITING LIST, ETC
0003 = VARIETY OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER
0004 = RESPONDENT WAS TOLD; NOT SICK ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9991 = OTHER SPECIFIED
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IN9DA 661 YOU FELT THAT YOU NEEDED MENTAL HEALTH SERVICES, BUT DID NOT RECEIVE THEM?
___________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9DB - IN9DG
IN9DB 662 YOU FELT THAT YOU NEEDED MENTAL HEALTH SERVICES. DO YOU KNOW WHERE YOU CAN GO TO GET
MENTAL HEALTH SERVICES?
________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9DA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(104)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9DC 663 (IF YOU KNEW WHERE TO GO) DID YOU HAVE INSURANCE THAT WOULD PAY FOR MENTAL HEALTH
SERVICES?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9DA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IN9DD
IN9DD 664 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR MENTAL HEALTH SERVICES YOURSELF?
_______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9DA, OR CODED 1 IN IN9DC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9DE 665 (IF YOU KNEW WHERE TO GO) DID YOU HAVE TRANSPORTATION TO GET MENTAL HEALTH SERVICES?
_____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9DA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9DF 666 BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID ANYONE REFUSE TO PROVIDE MENTAL HEALTH
SERVICES TO YOU?
_________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9DA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9DG
(105)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9DG 667-670 WHY WERE YOU REFUSED MENTAL HEALTH SERVICES? RECORD VERBATIM.
_______________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9DA, OR CODED 2, 7, 8 OR 9 IN
IN9DF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE, WAITING LIST, ETC
0003 = VARIETY OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER
0004 = RESPONDENT WAS TOLD; NOT SICK ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9991 = OTHER SPECIFIED
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IN9EA 671 YOU FELT THAT YOU NEEDED RESIDENTIAL CARE, BUT DID NOT RECEIVE IT?
___________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9EB - IN9EG
IN9EB 672 YOU FELT THAT YOU NEEDED RESIDENTIAL CARE. DO YOU KNOW WHERE YOU CAN GO TO GET
RESIDENTIAL CARE?
__________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9EA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(106)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9EC 673 (IF YOU KNEW WHERE TO GO) DID YOU HAVE INSURANCE THAT WOULD PAY FOR RESIDENTIAL CARE?
______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9EA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IN9ED
IN9ED 674 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR RESIDENTIAL CARE YOURSELF?
_________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9EA, OR CODED 1 IN IN9EC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9EE 675 (IF YOU KNEW WHERE TO GO) DID YOU HAVE TRANSPORTATION TO GET RESIDENTIAL CARE?
_______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9EA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9EF 676 BETWEEN (REF. DATE) AND AUGUST 31, 1992 DID ANYONE REFUSE TO PROVIDE RESIDENTIAL CARE TO
YOU?
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9EA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9EG
(107)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9EG 677-680 WHY WERE YOU REFUSED RESIDENTIAL CARE? RECORD VERBATIM.
_________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9EA, OR CODED 2, 7, 8 OR 9 IN
IN9EF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE, WAITING LIST, ETC
0003 = VARIETY OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER
0004 = RESPONDENT WAS TOLD; NOT SICK ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9991 = OTHER SPECIFIED
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IN9FA 681 YOU FELT THAT YOU NEEDED PRESCRIBED MEDICATION, BUT DID NOT RECEIVE IT?
________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9FB - IN9FG
IN9FB 682 YOU FELT THAT YOU NEEDED PRESCRIBED MEDICATION. DID YOU KNOW WHERE YOU CAN GO TO GET
PRESCRIBED MEDICATION?
_______________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9FA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(108)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9FC 683 (IF YOU KNEW WHERE TO GO) DID YOU HAVE INSURANCE THAT WOULD PAY FOR PRESCRIBED
MEDICATION?
____________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9FA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IN9FD
IN9FD 684 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR PRESCRIBED MEDICATION YOURSELF?
______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9FA, OR CODED 1 IN IN9FC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9FE 685 (IF YOU KNEW WHERE TO GO) DID YOU HAVE TRANSPORTATION TO GET PRESCRIBED MEDICATION?
____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9FA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9FF 686 BETWEEN (REF. DATE) AND AUGUST 31, 1992 DID ANYONE REFUSE TO PROVIDE PRESCRIBED
MEDICINES TO YOU?
__________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9FA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9FG
(109)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9FG 687-690 WHY WERE YOU REFUSED PRESCRIBED MEDICATION? RECORD VERBATIM.
______________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9FA, OR CODED 2, 7, 8 OR 9 IN
IN9FF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE, WAITING LIST, ETC
0003 = VARIETY OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER
0004 = RESPONDENT WAS TOLD; NOT SICK ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9991 = OTHER SPECIFIED
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IN9GA 691 YOU FELT THAT YOU NEEDED DENTAL SERVICES, BUT DID NOT RECEIVE THEM?
____________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9GB - IN9GG
IN9GB 692 YOU FELT THAT YOU NEEDED DENTAL SERVICES. DID YOU KNOW WHERE YOU CAN GO TO GET DENTAL
SERVICES?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9GA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(110)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9GC 693 (IF YOU KNEW WHERE TO GO) DID YOU HAVE INSURANCE THAT WOULD PAY FOR DENTAL SERVICES?
_____________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9GA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IN9GD
IN9GD 694 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR DENTAL SERVICES YOURSELF?
________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9GA, OR CODED 1 IN IN9GC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9GE 695 (IF YOU KNEW WHERE TO GO) DID YOU HAVE TRANSPORTATION TO GET DENTAL SERVICES?
______________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9GA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9GF 696 BETWEEN (REF. DATE) AND AUGUST 31, 1992 DID ANYONE REFUSE TO PROVIDE DENTAL SERVICES TO
YOU?
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9GA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9GG
(111)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9GG 697-700 WHY WERE YOU REFUSED DENTAL SERVICES? RECORD VERBATIM.
________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9GA, OR CODED 2, 7, 8 OR 9 IN
IN9GF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE, WAITING LIST, ETC
0003 = VARIETY OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER
0004 = RESPONDENT WAS TOLD; NOT SICK ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9991 = OTHER SPECIFIED
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IN9HA 701 YOU FELT THAT YOU NEEDED DRUG TREATMENT SERVICES, BUT DID NOT RECEIVE THEM?
____________________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9HB - IN9HG
IN9HB 702 YOU FELT THAT YOU NEEDED DRUG TREATMENT SERVICES. DID YOU KNOW WHERE YOU CAN GO TO GET
DRUG TREATMENT SERVICES?
_________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9HA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(112)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9HC 703 (IF YOU KNEW WHERE TO GO) DID YOU HAVE INSURANCE THAT WOULD PAY FOR DRUG TREATMENT
SERVICES?
__________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9HA.
* 1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
* SKIP IN9HD
IN9HD 704 (IF YOU KNEW WHERE TO GO) COULD YOU AFFORD TO PAY FOR DRUG TREATMENT SERVICES YOURSELF?
________________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9HA; OR CODED 1 IN IN9HC.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9HE 705 (IF YOU KNEW WHERE TO GO) DID YOU HAVE TRANSPORTATION TO GET DRUG TREATMENT SERVICES?
______________________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9HA.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IN9HF 706 BETWEEN (REF. DATE) AND AUGUST 31, 1992 DID ANYONE REFUSE TO PROVIDE DRUG TREATMENT TO
YOU?
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9HA.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IN9HG
(113)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IN9HG 707-710 WHY WERE YOU REFUSED DRUG TREATMENT SERVICES? RECORD VERBATIM.
________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IN9HA; OR CODED 2, 7, 8 OR 9 IN
IN9HF.
0001 = DISEASE RELATED REASON; EX-HIV POSITIVE/DRUG ADDICT, ETC
0002 = PROVIDER STATED; NO ROOM/NOT ENOUGH AVAILABLE, WAITING LIST, ETC
0003 = VARIETY OF REASONS PATIENT COULDN'T PAY; INCLUDING WOULD NOT TAKE
MEDICAID, INSURANCE WOULD NOT COVER
0004 = RESPONDENT WAS TOLD; NOT SICK ENOUGH/DON'T NEED/NOTHING THEY COULD DO FOR
ME
0005 = PATIENT NOT ELIGIBLE FOR SERVICE
0006 = SERVICE NOT AVAILABLE FROM PROVIDER
9991 = OTHER SPECIFIED
9992 = RESPONDENT DOES NOT ANSWER QUESTION
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IN9IA 711 YOU FELT THAT NO SERVICES WERE NEEDED?
_______________________________________
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IEMPLYMT (712-807) EMPLOYMENT AND INCOME
_____________________
IO1 712 ARE YOU CURRENTLY WORKING FULL-TIME, PART-TIME, OR ARE YOU CURRENTLY NOT WORKING?
__________________________________________________________________________________
* 1 = FULL - TIME
2 = PART - TIME
** 3 = NOT WORKING
** 7 = REFUSED
** 8 = DK
** 9 = NOT ASCERTAINED
* SKIP IOBOX2 - IOBOX3
** SKIP IOBOX2
(114)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IOBOX2 713 R CURRENTLY WORKING PART-TIME. LOOK AT FACE SHEETS. LAST TIME R WAS:
_______________________________________________________________________
+ = INAPPLICABLE, CODED 1, 3, 7, 8 OR 9 IN IO1
* 1 = WORKING FULL TIME (FT)
** 2 = WORKING PART -TIME (PT)
** 3 = NOT WORKING (NW)
* SKIP IOBOX3 - IO6
** SKIP IOBOX3 - IO15
IOBOX3 714 R CURRENTLY NOT WORKING. LOOK AT FACE SHEETS. LAST TIME R WAS:
_________________________________________________________________
+ = INAPPLICABLE, CODED 1 OR 2 IN IO1.
* 1 = WORKING FULL TIME (FT)
* 2 = WORKING PART -TIME (PT)
** 3 = NOT WORKING (NW)
* SKIP IO2 - IO21
** SKIP IO2 - IO27
IO2 715-717 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN IO1.
001-050 = HOURS PER WEEK
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IO3O4 718-721 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT
THIS JOB?
CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION,
1983.
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN IO1.
0001-9990 = 1983 CENSUS OCCUPATIONAL CODES
9994 = UNCODEABLE
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
(115)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO4A 722 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK?
WOULD YOU SAY IT WAS:
______________________
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN IO1.
1 = LESS THAN 25 PEOPLE
2 = 25 - 99 PEOPLE
3 = 100 - 499 PEOPLE
4 = 500 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IO5 723 BETWEEN (REF. DATE) AND AUGUST 31, 1992 HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR
AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS?
_______________________________________________
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN IO1.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO6 - IO30
IO6 724-725 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 2, 3, 7, 8 OR 9 IN IO1; OR CODED 2, 7, 8 OR 9 IN IO5
* 01 = STOPPED/QUIT/WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
* 02 = CAN'T DO WHAT I USED TO DO
* 03 = CHANGE TYPE/AMOUNT OF WORK
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IO7 - IO30
(116)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO7 726-728 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
001-050 = HOURS PER WEEK
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IO8O9 729-732 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT
THIS JOB?
CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION,
1983.
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
0001-9990 = CODES IN STANDARD OCCUPATIONAL CLASSIFICATION INDEX
9994 = UNCODEABLE
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
IO9A 733 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK?
WOULD YOU SAY IT WAS:
______________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
1 = LESS THAN 25 PEOPLE
2 = 25 - 99 PEOPLE
3 = 100 - 499 PEOPLE
4 = 500 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(117)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO10 734 ARE YOU ACTIVELY LOOKING FOR (FULL-TIME) WORK?
_______________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IO11 735-736 DID YOU STOP WORKING AT YOUR (LAST) JOB BECAUSE YOU TOOK A LEAVE OF ABSENCE OR DISABILITY
LEAVE, BECAUSE YOU QUIT, WERE LAID OFF, WERE FIRED, WERE TOO ILL OR FOR SOME OTHER
REASON?
________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
01 = LEAVE OF ABSENCE/DISABILITY LEAVE
02 = QUIT
03 = LAID OFF
04 = FIRED
05 = TOO ILL
06 = PREGNANCY
07 = ARRESTED/IN PRISON
08 = RETIRED
09 = KEPT SAME JOB CHANGED TO PT
10 = MOVED/LEFT AREA
11 = JOB ENDED OR BUSINESS CLOSED/MOVED/WAS SOLD
12 = WENT TO SCHOOL
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IO12 737 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED?
_________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
(118)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO13 (738-741) IN WHAT MONTH AND YEAR DID YOU LEAVE THAT (FULL TIME) JOB?
CODER: IF IO13YR EQUALS 97, 98 OR 99, CODE 99 IN IO13MO.
IO13MO 738-739 MONTH THAT LEAVE BEGAN
______________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IO13YR 740-741 YEAR THAT LEAVE BEGAN
_____________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IO14 742 SINCE (REF. DATE), HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR AMOUNT OF WORK YOU DO
BECAUSE OF YOUR ILLNESS?
_________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO15 - IO30
(119)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO15 743-744 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 2 OR 3 IN IOBOX2; OR CODED 1, 2 OR
3 IN IOBOX3; OR CODED 2, 7, 8 OR 9 IN IO14.
* 01 = STOPPED/QUIT/WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
* 02 = CAN'T DO WHAT I USED TO DO
* 03 = CHANGE TYPE/AMOUNT OF WORK
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IO16 - IO30
IO16 745-747 ABOUT HOW MANY HOURS DO YOU CURRENTLY WORK AT THIS JOB IN THE AVERAGE WEEK?
____________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1 IN IOBOX2; OR CODED 1, 2 OR 3 IN
IOBOX3.
001-050 = HOURS PER WEEK
997 = REFUSED
998 = DK
999 = NOT ASCERTAINED
IO17O18 748-751 WHAT IS YOUR CURRENT OCCUPATION? WHAT ARE YOUR MOST IMPORTANT ACTIVITIES OR DUTIES AT
THIS JOB?
CODER: USE CODES IN ALPHABETICAL INDEX OF INDUSTRIES AND OCCUPATIONS, FINAL EDITION,
1983.
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1 IN IOBOX2; OR CODED 1, 2 OR 3 IN
IOBOX3.
0001-9990 = CODES IN STANDARD OCCUPATIONAL CLASSIFICATION INDEX
9994 = UNCODEABLE
9997 = REFUSED
9998 = DK
9999 = NOT ASCERTAINED
(120)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO18A 752 ABOUT HOW MANY PERSONS ARE EMPLOYED IN A USUAL WEEK AT THE LOCATION WHERE YOU WORK?
WOULD YOU SAY IT WAS:
______________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1 IN IOBOX2; OR CODED 1, 2 OR 3 IN
IOBOX3.
1 = LESS THAN 25 PEOPLE
2 = 25 - 99 PEOPLE
3 = 100 - 499 PEOPLE
4 = 500 OR MORE
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IO19 753 ARE YOU ACTIVELY LOOKING FOR FULL TIME WORK?
_____________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1 IN IOBOX2; OR CODED 1, 2 OR 3 IN
IOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IO20 754 BETWEEN (REF. DATE) AND AUGUST 31, 1992 HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR
AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS?
_______________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1 IN IOBOX2; OR CODED 1, 2 OR 3 IN
IOBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO21 - IO30
(121)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO21 755-756 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1 IN IOBOX2; OR CODED 1, 2 OR 3 IN
IOBOX3; OR CODED 2, 7, 8 OR 9 IN IO20.
* 01 = STOPPED/QUIT/WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
* 02 = CAN'T DO WHAT I USED TO DO
* 03 = CHANGE TYPE/AMOUNT OF WORK
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IO22 - IO30
IO22 757 ARE YOU ACTIVELY LOOKING FOR (FULL-TIME) WORK?
_______________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 3 IN
IOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IO23 758-759 DID YOU STOP WORKING AT YOUR (LAST) JOB BECAUSE YOU TOOK A LEAVE OF ABSENCE OR DISABILITY
LEAVE, BECAUSE YOU QUIT, WERE LAID OFF, WERE FIRED, WERE TOO ILL OR FOR SOME OTHER
REASON?
________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 3 IN
IOBOX3.
01 = LEAVE OF ABSENCE/DISABILITY LEAVE
02 = QUIT
03 = LAID OFF
04 = FIRED
05 = TOO ILL
06 = PREGNANCY
07 = ARRESTED/IN PRISON
08 = RETIRED
09 = KEPT SAME JOB CHANGED TO PT
10 = MOVED/LEFT AREA
11 = JOB ENDED OR BUSINESS CLOSED/MOVED/WAS SOLD
12 = WENT TO SCHOOL
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(122)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO24 760 WAS IT BECAUSE OF YOUR HIV INFECTION THAT THIS HAPPENED?
_________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 3 IN
IOBOX3.
1 = YES
2 = NO
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IO25 (761-764) IN WHAT MONTH AND YEAR DID YOU LEAVE THAT JOB?
CODER: IF IO25YR EQUALS 97, 98 OR 99, CODE 99 IN IO25MO.
IO25MO 761-762 MONTH THAT LEAVE BEGAN
______________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 3 IN
IOBOX3.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IO25YR 763-764 YEAR THAT LEAVE BEGAN
_____________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 3 IN
IOBOX3.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(123)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO26 765 BETWEEN (REF. DATE) AND AUGUST 31, 1992 HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR
AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS?
_______________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 3 IN
IOBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO27 - IO30
IO27 766-767 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 3 IN
IOBOX3; OR CODED 2, 7, 8 OR 9 IN IO26.
* 01 = STOPPED/QUIT/WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
* 02 = CAN'T DO WHAT I USED TO DO
* 03 = CHANGE TYPE/AMOUNT OF WORK
* 91 = OTHER SPECIFIED
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IO28 - IO30
IO28 768 ARE YOU ACTIVELY LOOKING FOR FULL TIME WORK?
_____________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 1 OR
2 IN IOBOX3.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO29 - IO30
(124)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO29 769 BETWEEN (REF. DATE) AND AUGUST 31, 1992 HAVE YOU HAD TO MAKE ANY CHANGES IN THE TYPE OR
AMOUNT OF WORK YOU DO BECAUSE OF YOUR ILLNESS?
_______________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 1 OR
2 IN IOBOX3; OR CODED 2, 7, 8 OR 9 IN IO28.
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO30
IO30 770-771 WHAT TYPE OF CHANGE(S) DID YOU MAKE? RECORD VERBATIM.
_______________________________________________________
+ = INAPPLICABLE, CODED 1 IN IO1; OR CODED 1, 2 OR 3 IN IOBOX2; OR CODED 1 OR
2 IN IOBOX3; OR CODED 2, 7, 8 OR 9 IN IO28; OR CODED 2, 7, 8 OR 9 IN
IO29.
01 = STOPPED/QUIT/WORKING/UNABLE TO WORK DUE TO HEALTH PROBLEMS
02 = CAN'T DO WHAT I USED TO DO
03 = CHANGE TYPE/AMOUNT OF WORK
91 = OTHER SPECIFIED
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(125)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO31 772-773 WOULD YOU PLEASE LOOK AT THIS CARD AND TELL ME WHICH NUMBER REPRESENTS YOUR TOTAL INCOME
BEFORE TAXES FOR THE PAST MONTH. INCLUDE INCOME FROM ALL SOURCES: YOUR SALARIES, WAGES,
SOCIAL SECURITY, WELFARE AND ANY OTHER INCOME. IF YOU SHARE OR RECEIVE INCOME FROM A
SPOUSE/PARTNER, PLEASE INCLUDE IT IN HERE. CIRCLE ONE CODE.
_____________________________________________________________
01 = $ 0 -200/MO
02 = $ 201 -350/MO
03 = $ 351 -500/MO
04 = $ 501 -750/MO
05 = $ 751 -900/MO
06 = $ 901 -1,150/MO
07 = $ 1,151 -1,300/MO
08 = $ 1,301 -1,450/MO
09 = $ 1,451 -1,600/MO
10 = $ 1,601 -1,750/MO
11 = $ 1,751 -2000/MO
12 = $ 2,001 -3000/MO
13 = $ 3,001 -4,000/MO
14 = $ 4,001 OR MORE/MO
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IOBOX4 774 R WORKING FULL TIME (Q.O-1)
___________________________
* 1 = YES
2 = NO
* SKIP IO32 - IO41YR
IO32 775 BETWEEN (REF. DATE) AND AUGUST 31, 1992 HAVE YOU RECEIVED ANY SOCIAL SECURITY DISABILITY
PAYMENTS?
__________
+ = INAPPLICABLE, CODED 1 IN IOBOX4
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO33MO - IO33BX
IO33 (776-780) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST SOCIAL SECURITY DISABILITY PAYMENT?
______________________________________________________________________________________
(126)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO33DT (776-779) DATE YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT
CODER: IF IO33YR EQUALS 97, 98 OR 99, CODE 99 IN IO33MO.
IO33MO 776-777 MONTH YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT
___________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 2, 7, 8 OR 9 IN IO32; OR CODED
IN IO33BX.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IO33YR 778-779 YEAR YOU RECEIVED FIRST SOCIAL SECURITY DISABILITY PAYMENT
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 2, 7, 8 OR 9 IN IO32; OR CODED
IN IO33BX.
* 92 = YEAR
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IO33BX - IO35
IO33BX 780 FIRST SOCIAL SECURITY DISABILITY PAYMENT BEFORE (REF. DATE)
____________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 2, 7, 8 OR 9 IN IO32; OR CODED
IN IO33DT
* 1 = CHECKED
* SKIP IO34 - IO35
(127)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO34 781 HAVE YOU APPLIED FOR SOCIAL SECURITY DISABILITY PAYMENTS?
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 1 IN IO32
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO35
IO35 782 HAVE YOU BEEN TURNED DOWN FOR SOCIAL SECURITY DISABILITY?
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 1 IN IO32; OR CODED 2, 7, 8 OR
9 IN IO35
1 = YES
2 = NO/NO DECISION YET
7 = REFUSED
8 = DK
9 = NOT ASCERTAINED
IOBOX5 783 R HAS: CHILDREN (SEE FLAP)
___________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4.
* 1 = NO CHILDREN LIVING WITH THEM
2 = 1 OR MORE CHILDREN LIVING WITH THEM
* SKIP IO36 - IO37BX
IO36 784 SINCE (REF. DATE) HAVE YOU RECEIVED ASSISTANCE THROUGH THE AID TO FAMILIES WITH
DEPENDENT CHILDREN PROGRAM, SOMETIMES CALLED AFDC OR ADC?
__________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 1 IN IOBOX5
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO37MO - IO37BX
(128)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO37 (785-789) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST AFDC PAYMENT?
________________________________________________________________
IO37DT (785-788) DATE YOU RECEIVED YOUR FIRST AFDC PAYMENT
CODER: IF IO37YR EQUALS 97, 98 OR 99, CODE 99 IN IO37MO.
IO37MO 785-786 MONTH YOU RECEIVED YOUR FIRST AFDC PAYMENT.
____________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 1 IN IOBOX5; OR CODED 2, 7, 8
OR 9 IN IO36; OR CODED IN IO37BX
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IO37YR 787-788 YEAR YOU RECEIVED YOUR FIRST AFDC PAYMENT
_________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 1 IN IOBOX5; OR CODED 2, 7, 8
OR 9 IN IO36; OR CODED IN IO37BX
* 92 = YEAR
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IO37BX
IO37BX 789 FIRST AFDC PAYMENT BEFORE (REF. DATE)
______________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 1 IN IOBOX5; OR CODED 2, 7, 8
OR 9 IN IO36; OR CODED IN IO37DT
1 = CHECKED
(129)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO38 790 SINCE (REF. DATE) HAVE YOU RECEIVED THE SUPPLEMENTAL SECURITY INCOME OR SSI CHECK?
____________________________________________________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO39MO - IO39BX
IO39 (791-795) IN WHAT MONTH AND YEAR DID YOU RECEIVE YOUR FIRST SSI PAYMENT?
_______________________________________________________________
IO39DT (791-794) DATE YOU RECEIVED YOUR FIRST SSI PAYMENT
CODER: IF IO39YR EQUALS 97, 98 OR 99, CODE 99 IN IO39MO.
IO39MO 791-792 MONTH
_____
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 2, 7, 8 OR 9 IN IO38; OR CODED
IN IO39BX
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IO39YR 793-794 YEAR
____
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 2, 7, 8 OR 9 IN IO38; OR CODED
IN IO39BX
* 92 = YEAR
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IO39BX
(130)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO39BX 795 FIRST SSI PAYMENT BEFORE (REF. DATE)
_____________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED IN IO39DT.
1 = CHECKED
IO40 796 SINCE (REF. DATE) HAVE YOU RECEIVED FOOD STAMPS?
__________________________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO41MO - IO41YR
IO41 (797-800) IN WHAT MONTH DID YOU FIRST RECEIVE FOOD STAMPS?
CODER: IF IO41YR EQUALS 97, 98 OR 99, CODE 99 IN IO41MO.
IO41MO 797-798 MONTH YOU FIRST RECEIVED FOOD STAMPS
____________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 2, 7, 8 OR 9 IN IO40
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IO41YR 799-800 YEAR YOU FIRST RECEIVED FOOD STAMPS
___________________________________
+ = INAPPLICABLE, CODED 1 IN IOBOX4; OR CODED 2, 7, 8 OR 9 IN IO40
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(131)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IO42 801 SINCE (REF. DATE) HAVE YOU REGULARLY RECEIVED FINANCIAL SUPPORT, LIKE MONEY TO PAY BILLS
OR FOR FOOD OR RENT, FROM YOUR PARENTS, FRIENDS OR FAMILY MEMBERS?
___________________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IO43
IO43 802-807 HOW MUCH HAVE YOU RECEIVED SINCE (REF. DATE)?
CODER: CODE AMOUNTS IN WHOLE DOLLARS
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IO42
000001-999996 = AMOUNT RECEIVED
999997 = REFUSED
999998 = DK
999999 = NOT ASCERTAINED
TIMEGAPS (808-885) TIME GAPS
_________
IP1 808 BETWEEN (REF. DATE) AND AUGUST 31, 1992, DID YOU TRAVEL OUTSIDE THE UNITED STATES, NOT
INCLUDING PUERTO RICO, FOR A PERIOD OF TWO WEEKS OR LONGER?
____________________________________________________________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IP2 - IP3R3YR
(132)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP2 809-810 HOW MANY DIFFERENT TIMES DID YOU TRAVEL OUTSIDE THE UNITED STATES,NOT INCLUDING PUERTO
RICO, FOR TWO WEEKS OR LONGER BETWEEN(REF. DATES) AND AUGUST 31, 1992?
________________________________________________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2
01-96 = NUMBER
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IP3L1MO - IP3R3YR
IP3 (811-846) WHAT WAS THE DATE YOU LEFT THE UNITED STATES THE (FIRST/NEXT) TIME? WHAT WAS THE DATE
YOU RETURNED TO THE UNITED STATES THE (FIRST/NEXT) TIME?
CODER: IF "YR" EQUALS 97, 98 OR 99, CODE 99 IN "MO" AND "DY".
TRIP1 (811-822) FIRST TRIP
__________
IP3L1MO 811-812 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3L1DY 813-814 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(133)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP3L1YR 815-816 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3R1MO 817-818 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2
01-12 = MONTH
95 = STILL OUTSIDE OF U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3R1DY 819-820 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2
01-31 = DAY
95 = STILL OUTSIDE OF U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3R1YR 821-822 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2
92 = YEAR
95 = STILL OUTSIDE OF U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
TRIP2 (823-834) SECOND TRIP
___________
(134)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP3L2MO 823-824 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3L2DY 825-826 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3L2YR 827-828 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3R2MO 829-830 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
01-12 = MONTH
95 = STILL OUTSIDE OF U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(135)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP3R2DY 831-832 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
01-31 = DAY
95 = STILL IN U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3R2YR 833-834 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
92 = YEAR
95 = STILL OUSIDE OF U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
TRIP3 (835-846) THIRD TRIP
__________
IP3L3MO 835-836 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3L3DY 837-838 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(136)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP3L3YR 839-840 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3R3MO 841-842 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
01-12 = MONTH
95 = STILL OUTSIDE OF U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3R3DY 843-844 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
01-31 = DAY
95 = STILL OUTSIDE OF U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP3R3YR 845-846 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP1; OR CODED 97, 98 OR 99 IN IP2 OR
NO OTHER TRIPS LISTED.
92 = YEAR
95 = STILL OUTSIDE OF U.S
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(137)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP4 847 BETWEEN (REF. DATE) AND AUGUST 31. 1992, HAVE YOU BEEN IN JAIL OR PRISON FOR TWO WEEKS
OR LONGER?
___________
1 = YES
* 2 = NO
* 7 = REFUSED
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IP5 - IP6EX3YR
IP5 848-849 HOW MANY DIFFERENT TIMES HAVE YOU BEEN IN JAIL OR PRISON FOR TWO WEEKS OR LONGER BETWEEN
(REF. DATE) AND AUGUST 31, 1992?
__________________________________
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5
01-96 = NUMBER
* 97 = REFUSED
* 98 = DK
* 99 = NOT ASCERTAINED
* SKIP IP6EN1MO - IP6EX3YR
IP6 (850-885) WHAT WAS THE DATE YOU ENTERED JAIL OR PRISON THE (FIRST/NEXT) TIME? WHAT WAS THE DATE
YOU WERE RELEASED FROM JAIL OR PRISON THE (FIRST/NEXT) TIME?
CODER: IF "YR" EQUALS 97, 98 OR 99, CODE 99 IN "MO" AND "DY".
PRISON1 (850-861) FIRST PRISON TERM
_________________
IP6EN1MO 850-851 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(138)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP6EN1DY 852-853 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EN1YR 854-855 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EX1MO 856-857 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5
01-12 = MONTH
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EX1DY 858-859 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5
01-31 = DAY
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EX1YR 860-861 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5
92 = YEAR
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(139)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
PRISON2 (862-873) SECOND PRISON TERM
__________________
IP6EN2MO 862-863 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EN2DY 864-865 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EN2YR 866-867 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EX2MO 868-869 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
01-12 = MONTH
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(140)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP6EX2DY 870-871 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
01-31 = DAY
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EX2YR 872-873 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
92 = YEAR
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
PRISON3 (874-885) THIRD PRISON TERM
_________________
IP6EN3MO 874-875 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO THER PRISON TERMS LISTED.
01-12 = MONTH
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EN3DY 876-877 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
01-31 = DAY
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
(141)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IP6EN3YR 878-879 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
92 = YEAR
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EX3MO 880-881 MONTH
_____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
01-12 = MONTH
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EX3DY 882-883 DAY
___
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
01-31 = DAY
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IP6EX3YR 884-885 YEAR
____
+ = INAPPLICABLE, CODED 2, 7, 8 OR 9 IN IP4; OR CODED 97, 98 OR 99 IN IP5 OR
NO OTHER PRISON TERMS LISTED.
92 = YEAR
95 = STILL IN PRISON
97 = REFUSED
98 = DK
99 = NOT ASCERTAINED
IINTOBS (886-897) INTERVIEWER OBSERVATIONS
________________________
(142)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IR1 886 PLEASE INDICATE YOUR CONFIDENCE IN THE RESPONDENT'S TRUTHFULNESS.
__________________________________________________________________
* 1 = VERY CONFIDENT
* 2 = CONFIDENT
3 = UNSURE
4 = DOUBTFUL
5 = VERY DOUBTFUL
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IR2
IR2 887-888 WHY?
_____
+ = INAPPLICABLE, CODED 1, 2, 8 OR 9 IN IR1
91 = FLAG FOR QUESTION ANSWERED
98 = DK
99 = NOT ASCERTAINED
IR3 889 PLEASE INDICATE YOUR CONFIDENCE IN THE RESPONDENT'S ACCURACY.
______________________________________________________________
* 1 = VERY CONFIDENT
* 2 = CONFIDENT
3 = UNSURE
4 = DOUBTFUL
5 = VERY DOUBTFUL
* 8 = DK
* 9 = NOT ASCERTAINED
* SKIP IR4
IR4 890-891 WHY?
_____
+ = INAPPLICABLE, CODED 1, 2, 8 OR 9 IN IR3.
91 = FLAG FOR QUESTION ANSWERED
98 = DK
99 = NOT ASCERTAINED
IR5 (892-897) GENERALLY THE RESPONDENT WAS:
______________________________
(143)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IR5A 892 ABLE TO UNDERSTAND QUESTIONS
____________________________
1-7 = DEGREE OF UNDERSTANDING
CODER: CODE 1 = ABLE TO UNDERSTAND QUESTIONS EASILY TO CODE 7 = HARDLY ABLE TO
UNDERSTAND THE QUESTION
8 = DK
9 = NOT ASCERTAINED
IR5B 893 COOPERATIVE
___________
1-7 = DEGREE OF COOPERATION
CODER: CODE 1 = COOPERATIVE TO CODE 7 = UNCOOPERATIVE
8 = DK
9 = NOT ASCERTAINED
IR5C 894 NO LANGUAGE PROBLEM
___________________
1-7 = DEGREE OF LANGUAGE PROBLEM
CODER: CODE 1 = NO LANGUAGE PROBLEM TO CODE 7 = SPOKE ENGLISH WITH DIFFICULTY
8 = DK
9 = NOT ASCERTAINED
IR5D 895 INTERVIEWED WITHOUT INTERRUPTION
________________________________
1-7 = DEGREE OF INTERRUPTIONS DURING INTERVIEW
CODER: CODE 1 = INTERVIEWED WITHOUT INTERRUPTION TO CODE 7 = INTERRUPTED OFTEN
8 = DK
9 = NOT ASCERTAINED
(144)
27 Jun. 1994
Record 01
Question Column
Name Number(s)
________ _________
IR5E 896 SOBER
_____
1-7 = LEVEL OF SOBRIETY
CODER: CODE 1 = SOBER TO CODE 7 = INEBRIATED/HIGH
8 = DK
9 = NOT ASCERTAINED
IR5F 897 PHYSICALLY OR MENTALLY FATIGUED
_______________________________
1-7 = LEVEL OF PHYSICAL/MENTAL FATIGUE
CODER: CODE 1 = NOT PHYSICALLY OR MENTALLY FATIGUED TO CODE 7 = PHYSICALLY OR MENTALLY
FATIGUED
8 = DK
9 = NOT ASCERTAINED
(145)
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 =====
ADM6 035-036 Record 01 003
AMBVS6 040-042 Record 01 003
===== E =====
ERVS6 043-045 Record 01 003
===== G =====
GAP6FLAG 034 Record 01 003
===== H =====
HCVS6 046-048 Record 01 003
HLTHSTAT (349-380) Record 01 055
===== I =====
I_NONMED (433-453) Record 01 069
IABOX1 (117-118) Record 01 014
IABOX1A 117 Record 01 014
IABOX1B 118 Record 01 014
IA01CT 055-056 Record 01 004
IA1AGE1 060-061 Record 01 005
IA1AGE10 114-115 Record 01 014
IA1AGE2 066-067 Record 01 006
IA1AGE3 072-073 Record 01 007
IA1AGE4 078-079 Record 01 008
IA1AGE5 084-085 Record 01 009
IA1AGE6 090-091 Record 01 010
IA1AGE7 096-097 Record 01 011
IA1AGE8 102-103 Record 01 012
IA1AGE9 108-109 Record 01 013
IA1REL1 057-058 Record 01 004
IA1REL10 111-112 Record 01 013
IA1REL2 063-064 Record 01 005
IA1REL3 069-070 Record 01 006
IA1REL4 075-076 Record 01 007
IA1REL5 081-082 Record 01 008
IA1REL6 087-088 Record 01 009
IA1REL7 093-094 Record 01 010
IA1REL8 099-100 Record 01 011
IA1REL9 105-106 Record 01 012
IA1SEX1 059 Record 01 004
IA1SEX10 113 Record 01 013
INDEX OF VARIABLES PAGE 002
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IA1SEX2 065 Record 01 005
IA1SEX3 071 Record 01 006
IA1SEX4 077 Record 01 007
IA1SEX5 083 Record 01 008
IA1SEX6 089 Record 01 009
IA1SEX7 095 Record 01 010
IA1SEX8 101 Record 01 011
IA1SEX9 107 Record 01 012
IA1SST1 062 Record 01 005
IA1SST10 116 Record 01 014
IA1SST2 068 Record 01 006
IA1SST3 074 Record 01 007
IA1SST4 080 Record 01 008
IA1SST5 086 Record 01 009
IA1SST6 092 Record 01 010
IA1SST7 098 Record 01 011
IA1SST8 104 Record 01 012
IA1SST9 110 Record 01 013
IA2 119 Record 01 015
IA3 120 Record 01 015
IA4 121 Record 01 015
IA5 122-123 Record 01 016
IA6 (124-129) Record 01 016
IA6A 124 Record 01 016
IA6B 125 Record 01 016
IA6C 126 Record 01 017
IA6D 127 Record 01 017
IA6E 128 Record 01 017
IA6F 129 Record 01 017
IBBOX10 220 Record 01 039
IBBOX2 131 Record 01 018
IBBOX3 132 Record 01 018
IBBOX4 152 Record 01 023
IBBOX5 175 Record 01 029
IBBOX6 184 Record 01 030
IBBOX7 185 Record 01 031
IBBOX8 204 Record 01 035
IBBOX9 211 Record 01 037
IBDAYS1 253-255 Record 01 043
IBINS1 243-245 Record 01 042
IBINS2 267-269 Record 01 045
IBINS3 287-289 Record 01 048
IBINS4 307-309 Record 01 050
IBINS5 335-337 Record 01 054
IBR1 240-242 Record 01 042
INDEX OF VARIABLES PAGE 003
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IBR2 264-266 Record 01 045
IBR3 284-286 Record 01 048
IBR4 304-306 Record 01 050
IBR5 332-334 Record 01 054
IB1 130 Record 01 018
IB10 160 Record 01 025
IB12 161 Record 01 025
IB13 162 Record 01 025
IB14 (163-174) Record 01 025
IB14A 163 Record 01 026
IB14B 164 Record 01 026
IB14C 165 Record 01 026
IB14D 166 Record 01 026
IB14E 167 Record 01 027
IB14F 168 Record 01 027
IB14G 169 Record 01 027
IB14H 170 Record 01 027
IB14I 171 Record 01 028
IB14J 172 Record 01 028
IB14K 173 Record 01 028
IB14L 174 Record 01 028
IB16 (176-179) Record 01 029
IB16MO 176-177 Record 01 029
IB16YR 178-179 Record 01 029
IB17 180 Record 01 029
IB18 181 Record 01 030
IB19 182 Record 01 030
IB2 133 Record 01 018
IB21 183 Record 01 030
IB22 186 Record 01 031
IB23 187 Record 01 031
IB24 (188-199) Record 01 031
IB24A 188 Record 01 032
IB24B 189 Record 01 032
IB24C 190 Record 01 032
IB24D 191 Record 01 032
IB24E 192 Record 01 033
IB24F 193 Record 01 033
IB24G 194 Record 01 033
IB24H 195 Record 01 033
IB24I 196 Record 01 034
IB24J 197 Record 01 034
IB24K 198 Record 01 034
IB24L 199 Record 01 034
IB25 (200-203) Record 01 035
INDEX OF VARIABLES PAGE 004
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IB25MO 200-201 Record 01 035
IB25YR 202-203 Record 01 035
IB26 205-206 Record 01 036
IB27 (207-210) Record 01 036
IB27MO 207-208 Record 01 036
IB27YR 209-210 Record 01 036
IB28 212 Record 01 037
IB29 213 Record 01 037
IB3 134 Record 01 019
IB31 (214-219) Record 01 037
IB31A (214-216) Record 01 037
IB31A1 214-215 Record 01 038
IB31A2 216 Record 01 038
IB31B (217-219) Record 01 038
IB31B1 217-218 Record 01 038
IB31B2 219 Record 01 039
IB32 221-226 Record 01 039
IB33 227-228 Record 01 040
IB34 229 Record 01 040
IB35 (230-236) Record 01 040
IB35A 230-235 Record 01 040
IB35B 236 Record 01 041
IB36AMT4 (317-323) Record 01 051
IB36A1 238 Record 01 041
IB36A2 262 Record 01 044
IB36A3 282 Record 01 047
IB36A4 302 Record 01 049
IB36A5 330 Record 01 053
IB36B1 239 Record 01 041
IB36B2 263 Record 01 045
IB36B3 283 Record 01 047
IB36B4 303 Record 01 050
IB36B5 331 Record 01 053
IB36C1 (240-245) Record 01 042
IB36C2 (264-269) Record 01 045
IB36C3 (284-289) Record 01 047
IB36C4 (304-309) Record 01 050
IB36C5 (332-337) Record 01 053
IB36DOL 317-322 Record 01 051
IB36D1 246-251 Record 01 042
IB36D2 270-275 Record 01 046
IB36D3 290-295 Record 01 048
IB36D4 310-315 Record 01 051
IB36D5 338-343 Record 01 054
IB36E1 252 Record 01 043
INDEX OF VARIABLES PAGE 005
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IB36E4 316 Record 01 051
IB36F1 256 Record 01 043
IB36F2 276 Record 01 046
IB36F3 296 Record 01 048
IB36F4 324 Record 01 052
IB36F5 344 Record 01 054
IB36G1 257-260 Record 01 044
IB36G2 277-280 Record 01 046
IB36G3 297-300 Record 01 049
IB36G4 325-328 Record 01 052
IB36G5 345-348 Record 01 055
IB36MAX 323 Record 01 052
IB361 237 Record 01 041
IB361E (252-255) Record 01 042
IB362 261 Record 01 044
IB363 281 Record 01 047
IB364 301 Record 01 049
IB365 329 Record 01 053
IB4 (135-146) Record 01 019
IB4A 135 Record 01 019
IB4B 136 Record 01 019
IB4C 137 Record 01 020
IB4D 138 Record 01 020
IB4E 139 Record 01 020
IB4F 140 Record 01 020
IB4G 141 Record 01 021
IB4H 142 Record 01 021
IB4I 143 Record 01 021
IB4J 144 Record 01 021
IB4K 145 Record 01 022
IB4L 146 Record 01 022
IB5 (147-150) Record 01 022
IB5MO 147-148 Record 01 022
IB5YR 149-150 Record 01 023
IB6 151 Record 01 023
IB7 153 Record 01 023
IB8 154-155 Record 01 024
IB9 (156-159) Record 01 024
IB9MO 156-157 Record 01 024
IB9YR 158-159 Record 01 024
ICAREACS (0001) Record 01 095
IC15 (349-353) Record 01 055
IC15A 349 Record 01 055
IC15B 350 Record 01 056
IC15C 351 Record 01 056
INDEX OF VARIABLES PAGE 006
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IC15D 352 Record 01 056
IC15E 353 Record 01 056
IC16 (354-371) Record 01 056
IC16A 354 Record 01 057
IC16B 355 Record 01 057
IC16C 356 Record 01 057
IC16D 357 Record 01 057
IC16E 358 Record 01 057
IC16F 359 Record 01 058
IC16G 360 Record 01 058
IC16H 361 Record 01 058
IC16I 362 Record 01 058
IC16J 363 Record 01 058
IC16K 364 Record 01 059
IC16L 365 Record 01 059
IC16M 366 Record 01 059
IC16N 367 Record 01 059
IC16O 368 Record 01 059
IC16P 369 Record 01 060
IC16Q 370 Record 01 060
IC16R 371 Record 01 060
IC17 372 Record 01 060
IC18 373 Record 01 061
IC19 (374-379) Record 01 061
IC19DY 376-377 Record 01 061
IC19MO 374-375 Record 01 061
IC19YR 378-379 Record 01 061
IC20 380 Record 01 062
IDNTLSRV (454-458) Record 01 072
IDRGSECT (491-571) Record 01 078
ID06CT 384-385 Record 01 062
ID1A 381 Record 01 062
ID1B 382-383 Record 01 062
IEMPLYMT (712-807) Record 01 114
IENDDT (023-028) Record 01 002
IENDDY 025-026 Record 01 002
IENDMO 023-024 Record 01 002
IENDYR 027-028 Record 01 002
IE08CT 389-390 Record 01 063
IE1A 386 Record 01 063
IE1B 387-388 Record 01 063
IFUNCTN (572-607) Record 01 086
IF1 391 Record 01 063
IF1A 392-393 Record 01 064
IF10CT 394-395 Record 01 064
INDEX OF VARIABLES PAGE 007
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IF11CT 399-400 Record 01 064
IF12CT 404-405 Record 01 065
IF13CT 409-410 Record 01 066
IF2 396 Record 01 064
IF2A 397-398 Record 01 064
IF3 401 Record 01 065
IF3A 402-403 Record 01 065
IF4 406 Record 01 065
IF4A 407-408 Record 01 065
IG1 411 Record 01 066
IG1A 412-413 Record 01 066
IG14CT 414-415 Record 01 066
IG15CT 419-420 Record 01 067
IG16CT 424-425 Record 01 068
IG17CT 427-428 Record 01 068
IG2 416 Record 01 067
IG2A 417-418 Record 01 067
IG3 421 Record 01 067
IG3A 422-423 Record 01 068
IG4 426 Record 01 068
IHOMHLTH (429-432) Record 01 068
IHSEHOLD (055-129) Record 01 004
IH1 429 Record 01 069
IH19CT 431-432 Record 01 069
IH2 430 Record 01 069
IINSCOVR (130-220) Record 01 017
IINTOBS (886-897) Record 01 142
IIPSTAYS (381-385) Record 01 062
IITYPE 014 Record 01 001
II1 433 Record 01 069
II2 436 Record 01 070
II21CT 434-435 Record 01 070
II22CT 437-438 Record 01 070
II23CT 440-441 Record 01 070
II24CT 443-444 Record 01 071
II25CT 446-447 Record 01 071
II26CT 449-450 Record 01 072
II27CT 452-453 Record 01 072
II3 439 Record 01 070
II4 442 Record 01 071
II5 445 Record 01 071
II6 448 Record 01 071
II7 451 Record 01 072
IJ1 454 Record 01 072
IJ1A 455-456 Record 01 073
INDEX OF VARIABLES PAGE 008
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IJ29CT 457-458 Record 01 073
IKSEX 459 Record 01 073
IK1 (460-466) Record 01 073
IK1A 460 Record 01 073
IK1B 461 Record 01 074
IK1C 462 Record 01 074
IK1D 463 Record 01 074
IK1E 464 Record 01 074
IK1F 465 Record 01 075
IK1G 466 Record 01 075
IK2 467 Record 01 075
IK3 468 Record 01 075
IK4PROV 469-475 Record 01 076
IK5 (476-483) Record 01 076
IK5A 476 Record 01 076
IK5B 477 Record 01 076
IK5C 478 Record 01 077
IK5D 479 Record 01 077
IK5E 480 Record 01 077
IK5F 481 Record 01 077
IK5FOS 482-483 Record 01 078
IK6 484 Record 01 078
IK7 485-486 Record 01 078
ILANG 016 Record 01 001
IL1 487 Record 01 079
IL2 488 Record 01 079
IL3 491 Record 01 079
IL32CT 489-490 Record 01 079
IL4 (494-565) Record 01 080
IL4A 494-496 Record 01 080
IL4B 497-499 Record 01 080
IL4C 500-502 Record 01 080
IL4CT 492-493 Record 01 079
IL4D 503-505 Record 01 080
IL4E 506-508 Record 01 081
IL4F 509-511 Record 01 081
IL4G 512-514 Record 01 081
IL4H 515-517 Record 01 081
IL4I 518-520 Record 01 082
IL4J 521-523 Record 01 082
IL4K 524-526 Record 01 082
IL4L 527-529 Record 01 082
IL4M 530-532 Record 01 083
IL4N 533-535 Record 01 083
IL4O 536-538 Record 01 083
INDEX OF VARIABLES PAGE 009
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IL4P 539-541 Record 01 083
IL4Q 542-544 Record 01 084
IL4R 545-547 Record 01 084
IL4S 548-550 Record 01 084
IL4T 551-553 Record 01 084
IL4U 554-556 Record 01 085
IL4V 557-559 Record 01 085
IL4W 560-562 Record 01 085
IL4X 563-565 Record 01 085
IL5 566-571 Record 01 086
IMEDVIST (391-410) Record 01 063
IM1 572 Record 01 086
IM10 (601-605) Record 01 093
IM10A 601 Record 01 093
IM10B 602 Record 01 093
IM10C 603 Record 01 094
IM10D 604 Record 01 094
IM10E 605 Record 01 094
IM11 606-607 Record 01 094
IM2 (573-588) Record 01 086
IM2A 573 Record 01 086
IM2B 574 Record 01 087
IM2C 575 Record 01 087
IM2D 576 Record 01 087
IM2E 577 Record 01 087
IM2F 578 Record 01 087
IM2G 579 Record 01 088
IM2H 580 Record 01 088
IM2I 581 Record 01 088
IM2J 582 Record 01 088
IM2K 583 Record 01 088
IM2L 584 Record 01 089
IM2M 585 Record 01 089
IM2N 586 Record 01 089
IM2O 587 Record 01 089
IM2P 588 Record 01 089
IM3 (589-594) Record 01 090
IM3A 589 Record 01 090
IM3B 590 Record 01 090
IM3C 591 Record 01 090
IM3D 592 Record 01 090
IM3E 593 Record 01 091
IM3F 594 Record 01 091
IM4 595 Record 01 091
IM5 596 Record 01 091
INDEX OF VARIABLES PAGE 010
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IM6 597 Record 01 092
IM7 598 Record 01 092
IM8 599 Record 01 092
IM9 600 Record 01 093
INURSHOM (386-390) Record 01 062
IN1 608 Record 01 095
IN2 (609-617) Record 01 095
IN2A 609-610 Record 01 095
IN2PROV 611-617 Record 01 095
IN3 618 Record 01 096
IN4 619 Record 01 096
IN5 620-621 Record 01 096
IN6 (622-626) Record 01 096
IN6HRS 625-626 Record 01 097
IN6MIN 622-624 Record 01 097
IN7 627 Record 01 097
IN8 (628-631) Record 01 097
IN8MOS 628-629 Record 01 097
IN8YRS 630-631 Record 01 098
IN9 (632-711) Record 01 098
IN9AA 632 Record 01 098
IN9AB 633 Record 01 098
IN9AC 634 Record 01 099
IN9AD 635 Record 01 099
IN9AE 636 Record 01 099
IN9AF 637 Record 01 099
IN9AG 638-641 Record 01 100
IN9BA 642 Record 01 100
IN9BB 643 Record 01 100
IN9BC 644 Record 01 101
IN9BD 645 Record 01 101
IN9BE 646 Record 01 101
IN9BF 647 Record 01 101
IN9BG 648-651 Record 01 102
IN9CA 652 Record 01 102
IN9CB 653 Record 01 102
IN9CC 654 Record 01 103
IN9CD 655 Record 01 103
IN9CF 656 Record 01 103
IN9CG 657-660 Record 01 104
IN9DA 661 Record 01 104
IN9DB 662 Record 01 104
IN9DC 663 Record 01 105
IN9DD 664 Record 01 105
IN9DE 665 Record 01 105
INDEX OF VARIABLES PAGE 011
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IN9DF 666 Record 01 105
IN9DG 667-670 Record 01 106
IN9EA 671 Record 01 106
IN9EB 672 Record 01 106
IN9EC 673 Record 01 107
IN9ED 674 Record 01 107
IN9EE 675 Record 01 107
IN9EF 676 Record 01 107
IN9EG 677-680 Record 01 108
IN9FA 681 Record 01 108
IN9FB 682 Record 01 108
IN9FC 683 Record 01 109
IN9FD 684 Record 01 109
IN9FE 685 Record 01 109
IN9FF 686 Record 01 109
IN9FG 687-690 Record 01 110
IN9GA 691 Record 01 110
IN9GB 692 Record 01 110
IN9GC 693 Record 01 111
IN9GD 694 Record 01 111
IN9GE 695 Record 01 111
IN9GF 696 Record 01 111
IN9GG 697-700 Record 01 112
IN9HA 701 Record 01 112
IN9HB 702 Record 01 112
IN9HC 703 Record 01 113
IN9HD 704 Record 01 113
IN9HE 705 Record 01 113
IN9HF 706 Record 01 113
IN9HG 707-710 Record 01 114
IN9IA 711 Record 01 114
IOBOX2 713 Record 01 115
IOBOX3 714 Record 01 115
IOBOX4 774 Record 01 126
IOBOX5 783 Record 01 128
IOTHPROV (411-428) Record 01 066
IO1 712 Record 01 114
IO10 734 Record 01 118
IO11 735-736 Record 01 118
IO12 737 Record 01 118
IO13 (738-741) Record 01 119
IO13MO 738-739 Record 01 119
IO13YR 740-741 Record 01 119
IO14 742 Record 01 119
IO15 743-744 Record 01 120
INDEX OF VARIABLES PAGE 012
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IO16 745-747 Record 01 120
IO17O18 748-751 Record 01 120
IO18A 752 Record 01 121
IO19 753 Record 01 121
IO2 715-717 Record 01 115
IO20 754 Record 01 121
IO21 755-756 Record 01 122
IO22 757 Record 01 122
IO23 758-759 Record 01 122
IO24 760 Record 01 123
IO25 (761-764) Record 01 123
IO25MO 761-762 Record 01 123
IO25YR 763-764 Record 01 123
IO26 765 Record 01 124
IO27 766-767 Record 01 124
IO28 768 Record 01 124
IO29 769 Record 01 125
IO3O4 718-721 Record 01 115
IO30 770-771 Record 01 125
IO31 772-773 Record 01 126
IO32 775 Record 01 126
IO33 (776-780) Record 01 126
IO33BX 780 Record 01 127
IO33DT (776-779) Record 01 127
IO33MO 776-777 Record 01 127
IO33YR 778-779 Record 01 127
IO34 781 Record 01 128
IO35 782 Record 01 128
IO36 784 Record 01 128
IO37 (785-789) Record 01 129
IO37BX 789 Record 01 129
IO37DT (785-788) Record 01 129
IO37MO 785-786 Record 01 129
IO37YR 787-788 Record 01 129
IO38 790 Record 01 130
IO39 (791-795) Record 01 130
IO39BX 795 Record 01 131
IO39DT (791-794) Record 01 130
IO39MO 791-792 Record 01 130
IO39YR 793-794 Record 01 130
IO4A 722 Record 01 116
IO40 796 Record 01 131
IO41 (797-800) Record 01 131
IO41MO 797-798 Record 01 131
IO41YR 799-800 Record 01 131
INDEX OF VARIABLES PAGE 013
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IO42 801 Record 01 132
IO43 802-807 Record 01 132
IO5 723 Record 01 116
IO6 724-725 Record 01 116
IO7 726-728 Record 01 117
IO8O9 729-732 Record 01 117
IO9A 733 Record 01 117
IPID01 001-009 Record 01 001
IPNGT6 037-039 Record 01 003
IP1 808 Record 01 132
IP2 809-810 Record 01 133
IP3 (811-846) Record 01 133
IP3L1DY 813-814 Record 01 133
IP3L1MO 811-812 Record 01 133
IP3L1YR 815-816 Record 01 134
IP3L2DY 825-826 Record 01 135
IP3L2MO 823-824 Record 01 135
IP3L2YR 827-828 Record 01 135
IP3L3DY 837-838 Record 01 136
IP3L3MO 835-836 Record 01 136
IP3L3YR 839-840 Record 01 137
IP3R1DY 819-820 Record 01 134
IP3R1MO 817-818 Record 01 134
IP3R1YR 821-822 Record 01 134
IP3R2DY 831-832 Record 01 136
IP3R2MO 829-830 Record 01 135
IP3R2YR 833-834 Record 01 136
IP3R3DY 843-844 Record 01 137
IP3R3MO 841-842 Record 01 137
IP3R3YR 845-846 Record 01 137
IP4 847 Record 01 138
IP5 848-849 Record 01 138
IP6 (850-885) Record 01 138
IP6EN1DY 852-853 Record 01 139
IP6EN1MO 850-851 Record 01 138
IP6EN1YR 854-855 Record 01 139
IP6EN2DY 864-865 Record 01 140
IP6EN2MO 862-863 Record 01 140
IP6EN2YR 866-867 Record 01 140
IP6EN3DY 876-877 Record 01 141
IP6EN3MO 874-875 Record 01 141
IP6EN3YR 878-879 Record 01 142
IP6EX1DY 858-859 Record 01 139
IP6EX1MO 856-857 Record 01 139
IP6EX1YR 860-861 Record 01 139
INDEX OF VARIABLES PAGE 014
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== I =====
IP6EX2DY 870-871 Record 01 141
IP6EX2MO 868-869 Record 01 140
IP6EX2YR 872-873 Record 01 141
IP6EX3DY 882-883 Record 01 142
IP6EX3MO 880-881 Record 01 142
IP6EX3YR 884-885 Record 01 142
IREC01 010-011 Record 01 001
IREFDT (017-022) Record 01 001
IREFDY 019-020 Record 01 002
IREFMO 017-018 Record 01 001
IREFYR 021-022 Record 01 002
IRTYPE 015 Record 01 001
IR1 886 Record 01 143
IR2 887-888 Record 01 143
IR3 889 Record 01 143
IR4 890-891 Record 01 143
IR5 (892-897) Record 01 143
IR5A 892 Record 01 144
IR5B 893 Record 01 144
IR5C 894 Record 01 144
IR5D 895 Record 01 144
IR5E 896 Record 01 145
IR5F 897 Record 01 145
ISREC01 012-013 Record 01 001
IWMNHLTH (459-486) Record 01 073
===== M =====
MDVS6 052-054 Record 01 004
===== O =====
OBSDAYS6 031-033 Record 01 002
OCVS6 049-051 Record 01 003
===== P =====
PERSON1 (057-062) Record 01 004
PERSON10 (111-116) Record 01 013
PERSON2 (063-068) Record 01 005
PERSON3 (069-074) Record 01 006
PERSON4 (075-080) Record 01 007
PERSON5 (081-086) Record 01 008
PERSON6 (087-092) Record 01 009
PERSON7 (093-098) Record 01 010
INDEX OF VARIABLES PAGE 015
Variable Name Column Numbers Record Number Codebook Page No.
------------- -------------- ------------- -----------------
===== P =====
PERSON8 (099-104) Record 01 011
PERSON9 (105-110) Record 01 012
PRISON1 (850-861) Record 01 138
PRISON2 (862-873) Record 01 140
PRISON3 (874-885) Record 01 141
PRVI (221) Record 01 039
===== T =====
TIMEGAPS (808-885) Record 01 132
TRIP1 (811-822) Record 01 133
TRIP2 (823-834) Record 01 134
TRIP3 (835-846) Record 01 136
T6_STAT 029-030 Record 01 002