Understanding and Analyzing MEPS Household Component Medical Condition Data
by Steven Machlin, Anita Soni, and Zhengyi Fang
Introduction
MEPS Household Component (MEPS-HC) respondents
are asked open-ended questions about their own medical conditions as well as
those of other family members’ in various sections of the computer assisted personal
interview (CAPI) questionnaire. A particular condition for an individual may be
reported in all, some, or none of these sections. This document describes the
reporting of medical conditions in MEPS and uses 2008 data to quantify the
extent to which sample persons’ conditions are reported in different sections
of the survey. A particular focus is on the extent to which the series of
questions related to medical events account for condition reporting in the
MEPS-HC.
^top
Condition Data Collection
Household respondents are asked open-ended
questions about MEPS sample persons’ medical conditions in the following
sections of the questionnaire: 1) Condition Enumeration (CE), 2) Medical Events
(ME) and 3) Disability Days (DD). The CE section is the first among these
sections and asks respondents to identify any specific physical or mental
health problems for the person during the interview reference period (regardless
of whether there was associated medical care or disability days). In most ME
sections (medical provider office visits (MV), emergency rooms (ER), outpatient
departments (OP), hospital inpatient stays (HS), prescribed medicine purchases
(PM) and home health providers (HH)), household respondents are asked to
identify the conditions that are associated with care/events they reported (conditions
are not asked in the dental (DN) or other medical (OM) event sections)). Finally,
conditions that caused sample persons to miss school or work, or spend more
than half a day in bed, are ascertained in the DD section.
A particular condition for a sample
person may be reported in all, some, or none of the sections described above.
Interview responses that identify conditions are recorded as verbatim text by
interviewers and then professionally coded for MEPS analytic files to
fully-specified ICD-9-CM codes. Specific questions for
each section with condition probes are provided in the Appendix.
In addition to open-ended reporting of
conditions in the CE, ME, and DD sections, the priority
condition enumeration section (PE) contains a
series of “yes/no” questions on whether the person has ever been diagnosed as
having each of several specific conditions that are generally chronic in nature.
These conditions, which include high blood pressure, heart disease, stroke,
emphysema, chronic bronchitis, high cholesterol, cancer, diabetes, joint pain,
arthritis, asthma, and attention deficit disorder/attention deficit
hyperactivity disorder, were deemed by the Agency for Healthcare Research and
Quality (AHRQ) as “priority” for the survey due to their relatively high prevalence
and generally accepted criteria for assessing appropriate clinical care. While
variables based on responses to the PE questions are included in the MEPS Full
Year Consolidated files, this report focuses only on the reporting of
conditions in the CE, ME, and DD sections (i.e., not PE) because these sections
have the potential to capture any condition and comprise the data in the MEPS
Medical Conditions public use files. However, because the PE questions are
asked prior to the CE, ME, and DD sections, reporting of the specific PE conditions
may be greater in these subsequent sections than would have occurred in the
absence of a PE section.
^top
MEPS Medical Conditions Files
Each record in a MEPS annual medical condition file represents a “current” condition
reported as existing for a MEPS sample person at any time during the specific
data year (i.e., those identified in the CE, ME, or DD sections of the
questionnaire). To preserve confidentiality, diagnosis condition codes provided on the Medical
Conditions file are collapsed from fully-specified 5-digit ICD-9-CM codes to
3-digit ICD-9-CM code categories.
The following table provides SAS code that can be used to identify
conditions in a Medical Condition file according to which section of the
questionnaire they were reported. This code reflects the methodology used to
develop table 1 for this report (see “Methods” section below).
CAPI section |
SAS
code |
Medical Events (ME) |
If HHNUM>0 or IPNUM>0 or OPNUM>0 or OBNUM>0 or ERNUM>0
or RXNUM>0 then Section=ME; |
Disability Days (DD) but not ME |
Else if MISSWORK=1 or MISSSCHL=1 or INBEDFLG=1 then Section=DD; |
Condition Enumeration (CE) only |
Else Section=CE_only; |
While it is reasonable to presume that many conditions reported in
the ME and/or DD sections were also reported in the CE section, only those
conditions reported exclusively in the CE can be identified based on
information provided in the Medical Conditions file (see SAS code in table above).
^top
Methods
Among persons with one or more records in the 2008 Medical
Conditions file, table 1 shows the distributions by MEPS questionnaire section that
the condition was reported for the 50 most common condition categories while table
2 provides two different types of population prevalence estimates for the 50
conditions. Persons are classified in table 1 into 3 mutually exclusive categories:
1) those with one or more medical events reported as associated with the
condition, 2) those with the condition reported in DD section but no associated
medical events reported, or 3) those with the condition reported in the CE
section only. Table 2 shows “total” population prevalence estimates based on
all persons and “treated” population estimates based on only persons with
associated medical event(s) reported. The condition categories were defined
using the Clinical
Classification Software (CCS) which is a tool developed by AHRQ
for clustering diagnoses into a manageable number of clinically meaningful policy-relevant
categories (see http://meps.ahrq.gov/mepsweb/data_stats/download_data/pufs/h120/h120doc.pdf for
crosswalk between CCS condition categories and component ICD-9-CM codes). The number of sample persons range across the 50 condition
categories from 177 to 6,469. All estimates were weighted by the MEPS
person-level weight (PERWT08F) to produce national estimates and standard
errors shown in table 2 were computed using a Taylor Series estimation
approach.
^top
Results
Table 1 shows that, in general, a high proportion of persons with
a condition reported in any section had the condition identified in the medical
events sections. For 32 of the 50 conditions shown, 80 percent or more of
persons had medical events associated with the condition. Moreover, 95 percent
or more of persons with thyroid disease (CCS=48), diabetes (CCS=49–50),
epilepsy/convulsions (CCS=83) or male genital disorders (CCS=164–166) in the
Medical Conditions file had medical events associated with the condition. In
contrast, only 30 percent of persons with influenza (CCS=123) and 23 percent of
those with an intestinal infection (CCS=135) reported in any section had a medical
event reported for those conditions. These two conditions were more likely to
be reported in the DD section (55 percent of those with influenza and 69
percent of those with intestinal infections reported). Other conditions with a
notable proportion of persons identified in the DD section (but not ME) include
acute bronchitis/upper respiratory infection (URI) (36 percent, CCS=125–126),
and headache (33 percent, CCS=84). Most conditions (42 of the 50) had less
than 10 percent reported in DD with no medical events reported for the same
condition. Finally, for all but three of the conditions, less than 20 percent
of persons were identified as having the condition in the CE section only. The
three conditions with more than 20 percent identified in the CE section only
were trauma-related disorders (21 percent, CCS=225–236 etc.), disorders of
teeth or jaws (25 percent, CCS=136), and osteoarthritis (33 percent, CCS=201–204).
Table 1. Percentage Distribution by Section in which Condition was Reported for Selected Condition Categories, 2008
CCS code(s) |
Condition category |
Number of persons unweighted) |
Percentage distribution of condition report by section, ME1 |
Percentage distribution of condition report by section, DD but not ME2 |
Percentage distribution of condition report by section, CE only |
1–9 |
Infectious diseases |
1,993 |
75.2 |
12.5 |
12.4 |
10, 254–258 |
Other care and screening |
1,866 |
84.6 |
2.7 |
12.7 |
11–45 |
Cancer |
1,321 |
89.0 |
1.2 |
9.9 |
46, 47 |
Non-malignant neoplasm |
381 |
83.6 |
1.7 |
14.7 |
48 |
Thyroid disease |
1,285 |
97.3 |
0.3 |
2.4 |
49, 50 |
Diabetes mellitus |
2,263 |
95.4 |
0.8 |
3.8 |
51, 52, 54–58 |
Other endocrine, nutritional, & immune disorder |
1,180 |
87.8 |
2.6 |
9.6 |
53 |
Hyperlipidemia |
4,488 |
87.2 |
0.1 |
12.6 |
59 |
Anemia and other deficiencies |
401 |
84.8 |
1.1 |
14.1 |
79–81 |
Hereditary, degenerative, and other nervous system disorders |
248 |
90.5 |
0.5 |
9.0 |
83 |
Epilepsy and convulsions |
242 |
95.2 |
0.8 |
4.1 |
84 |
Headache |
1,394 |
51.6 |
33.2 |
15.2 |
86 |
Cataract |
423 |
86.0 |
0.1 |
13.9 |
87, 89–91 |
Other eye disorders |
1,823 |
78.7 |
2.9 |
18.4 |
88 |
Glaucoma |
352 |
92.1 |
0.0 |
7.9 |
92 |
Otitis media |
1,164 |
81.6 |
6.8 |
11.6 |
93–95 |
Other central nervous system (CNS) disorders |
1,727 |
76.8 |
4.6 |
18.7 |
96, 97, 100–108 |
Heart conditions |
2,343 |
86.7 |
2.1 |
11.2 |
98, 99 |
Hypertension |
5,607 |
93.0 |
0.6 |
6.4 |
109–113 |
Cerebrovascular disease |
402 |
79.9 |
6.1 |
14.0 |
114–121 |
Other circulatory conditions arteries, veins, and lymphatics |
578 |
81.5 |
3.6 |
14.9 |
122 |
Pneumonia |
432 |
78.9 |
12.7 |
8.5 |
123 |
Influenza |
1,097 |
30.0 |
55.4 |
14.6 |
125, 126 |
Acute bronchitis and URI |
6,469 |
44.7 |
36.0 |
19.3 |
127–134 |
COPD, asthma |
6,105 |
74.2 |
8.6 |
17.3 |
135 |
Intestinal infection |
3,957 |
23.3 |
68.8 |
7.9 |
136 |
Disorders of teeth and jaws |
1,132 |
63.9 |
11.0 |
25.1 |
138–141 |
Disorders of the upper gastrointestinal (GI) |
2,602 |
81.0 |
12.0 |
6.9 |
143 |
Hernias |
240 |
80.7 |
5.7 |
13.6 |
144–148 |
Other stomach and intestinal disorders |
194 |
86.8 |
4.8 |
8.5 |
149–152 |
Gallbladder, pancreatic, and liver disease |
339 |
81.3 |
5.6 |
13.1 |
153–155 |
Other GI |
1,041 |
77.3 |
8.8 |
13.9 |
156–158, 160, 161 |
Kidney disease |
431 |
89.9 |
3.7 |
6.4 |
159 |
Urinary tract infections |
849 |
83.2 |
3.7 |
13.1 |
162, 163 |
Other urinary |
495 |
89.2 |
1.6 |
9.2 |
164–166 |
Male genital disorders |
410 |
95.0 |
0.5 |
4.6 |
167 |
Non-malignant breast disease |
195 |
84.4 |
0.7 |
14.9 |
168–176 |
Female genital disorders, and contraception |
1,398 |
86.3 |
6.7 |
7.0 |
177–195 |
Complications of pregnancy and birth |
192 |
78.1 |
9.3 |
12.6 |
196, 218 |
Normal birth/live born |
865 |
80.0 |
6.2 |
13.8 |
197–200 |
Skin disorders |
2,310 |
85.2 |
1.7 |
13.1 |
201–204 |
Osteoarthritis and other non-traumatic joint disorders |
5,014 |
62.7 |
4.6 |
32.8 |
205 |
Back problems |
2,076 |
75.8 |
7.2 |
17.0 |
206–209, 212 |
Other bone and musculoskeletal disease |
789 |
89.3 |
1.4 |
9.4 |
210–211 |
Systemic lupus and connective tissues disorders |
1,657 |
77.5 |
4.1 |
18.4 |
213–217 |
Congenital anomalies |
177 |
82.1 |
0.9 |
17.0 |
225–236, 239, 240, 244 |
Trauma-related disorders |
4,058 |
72.7 |
6.7 |
20.5 |
241–243 |
Poisoning by medical and non-medical substances |
242 |
74.7 |
9.4 |
15.9 |
253 |
Allergic reactions |
785 |
80.5 |
3.2 |
16.3 |
650–670 |
Mental disorders |
4,289 |
79.0 |
6.1 |
15.0 |
1 Condition may also have been reported in DD or CE sections.
2 Condition may also have been reported in CE section.
^top
Table 2 compares “total population prevalence” estimates
for the 50 condition categories based on the entire Medical Conditions file to
“treated population prevalence” estimates based only on condition records
associated with medical events. It is apparent from the table that the rank
orders of the two sets of population estimates are highly correlated (r=.98).
However, acute bronchitis/URI (CCS=125–126), intestinal infections (CCS=135),
and influenza (CCS=123) rank notably higher in terms of total reported
conditions than in terms of treated prevalence. The ratio of “treated
prevalence” to “total reported” population estimates ranges from 23 percent for intestinal infections (9,725,098/41,676,660) to 97
percent for thyroid disease (CCS=48) (15,434,555/15,869,425). In other words,
the 2008 MEPS treated prevalence population estimate for intestinal infections
is substantially lower than the total estimate (9.7 versus 41.7 million) while
treated prevalence and total prevalence estimates are similar for thyroid
disease (15.4 versus 15.9 million).
Table 2. Population Prevalence Estimates Based on Full Condition File Data versus only Persons w/ Medical Events, Selected Condition Categories, 2008
CCS code(s) |
Condition category |
Total (full conditions file), population |
Total (full conditions file), SE |
Total (full conditions file), rank |
Associated w/ medical event(s), population |
Associated w/ medical event(s), SE |
Associated w/ medical event(s), rank |
1–9 |
Infectious diseases |
21,989,219 |
788,465 |
14 |
16,526,955 |
625,421 |
14 |
10, 254–258 |
Other care and screening |
20,347,107 |
931,518 |
16 |
17,219,615 |
808,617 |
13 |
11–45 |
Cancer |
17,400,124 |
736,081 |
19 |
15,479,928 |
709,324 |
17 |
46, 47 |
Non-malignant neoplasm |
4,708,789 |
327,107 |
37 |
3,936,964 |
304,736 |
36 |
48 |
Thyroid disease |
15,869,425 |
705,056 |
20 |
15,434,555 |
687,100 |
18 |
49, 50 |
Diabetes mellitus |
22,170,464 |
723,833 |
13 |
21,157,779 |
717,549 |
11 |
51, 52, 54–58 |
Other endocrine, nutritional, and immune disorder |
13,226,874 |
531,229 |
23 |
11,608,845 |
512,025 |
21 |
53 |
Hyperlipidemia |
50,898,959 |
1,459,715 |
5 |
44,401,137 |
1,365,597 |
3 |
59 |
Anemia and other deficiencies |
3,619,403 |
234,119 |
41 |
3,069,478 |
219,283 |
41 |
79–81 |
Hereditary, degenerative and other nervous system disorders |
3,072,974 |
220,610 |
43 |
2,780,439 |
212,717 |
43 |
83 |
Epilepsy and convulsions |
2,603,482 |
212,087 |
46 |
2,477,566 |
207,632 |
44 |
84 |
Headache |
14,129,062 |
568,284 |
22 |
7,297,193 |
367,256 |
28 |
86 |
Cataract |
5,247,714 |
362,558 |
34 |
4,514,756 |
328,839 |
34 |
87, 89–91 |
Other eye disorders |
20,479,939 |
827,815 |
15 |
16,115,728 |
675,354 |
15 |
88 |
Glaucoma |
3,970,976 |
302,947 |
40 |
3,656,679 |
293,172 |
38 |
92 |
Otitis media |
11,783,337 |
520,238 |
24 |
9,619,883 |
449,185 |
23 |
93–95 |
Other CNS disorders |
20,196,297 |
707,327 |
17 |
15,503,906 |
634,403 |
16 |
96, 97, 100–108 |
Heart conditions |
26,788,637 |
936,846 |
10 |
23,234,187 |
879,698 |
8 |
98, 99 |
Hypertension |
59,334,619 |
1,556,908 |
3 |
55,197,052 |
1,490,396 |
1 |
109–113 |
Cerebrovascular disease |
4,610,873 |
320,606 |
38 |
3,684,310 |
290,958 |
37 |
114–121 |
Other circulatory conditions arteries, veins, and lymphatics |
6,768,348 |
338,658 |
32 |
5,517,244 |
289,264 |
31 |
122 |
Pneumonia |
4,527,763 |
305,919 |
39 |
3,571,130 |
285,979 |
39 |
123 |
Influenza |
10,657,800 |
683,241 |
27 |
3,201,693 |
262,339 |
40 |
125, 126 |
Acute bronchitis and URI |
68,738,432 |
1,895,626 |
1 |
30,735,580 |
928,828 |
7 |
127–134 |
COPD, asthma |
62,697,942 |
1,856,151 |
2 |
46,492,922 |
1,469,667 |
2 |
135 |
Intestinal infection |
41,676,660 |
1,423,233 |
8 |
9,725,098 |
514,380 |
22 |
136 |
Disorders of teeth and jaws |
11,477,850 |
540,660 |
25 |
7,331,240 |
383,290 |
27 |
138–141 |
Disorders of the upper GI |
27,790,982 |
857,891 |
9 |
22,521,248 |
714,505 |
9 |
143 |
Hernias |
2,787,080 |
211,583 |
45 |
2,248,293 |
186,716 |
46 |
144–148 |
Other stomach and intestinal disorders |
2,597,150 |
252,798 |
47 |
2,253,680 |
231,991 |
45 |
149–152 |
Gallbladder, pancreatic, and liver disease |
3,571,157 |
243,743 |
42 |
2,904,198 |
207,600 |
42 |
153–155 |
Other GI |
11,147,354 |
535,300 |
26 |
8,612,365 |
468,067 |
25 |
156–158, 160, 161 |
Kidney disease |
4,719,110 |
321,565 |
36 |
4,242,635 |
318,244 |
35 |
159 |
Urinary tract infections |
9,454,716 |
435,691 |
29 |
7,869,037 |
386,379 |
26 |
162, 163 |
Other urinary |
5,473,173 |
327,429 |
33 |
4,883,913 |
317,867 |
32 |
164–166 |
Male genital disorders |
5,097,348 |
338,889 |
35 |
4,840,044 |
325,804 |
33 |
167 |
Non-malignant breast disease |
2,164,857 |
197,391 |
48 |
1,827,690 |
174,594 |
48 |
168–176 |
Female genital disorders, and contraception |
15,812,862 |
637,006 |
21 |
13,644,918 |
617,463 |
20 |
177–195 |
Complications of pregnancy and birth |
1,751,045 |
186,002 |
50 |
1,367,201 |
152,547 |
50 |
196, 218 |
Normal birth/live born |
7,557,688 |
439,270 |
31 |
6,045,920 |
356,662 |
30 |
197-200 |
Skin disorders |
25,801,812 |
825,649 |
11 |
21,976,284 |
773,751 |
10 |
201–204 |
Osteoarthritis and other non-traumatic joint disorders |
55,944,585 |
1,719,769 |
4 |
35,053,634 |
1,133,487 |
5 |
205 |
Back problems |
23,606,471 |
802,807 |
12 |
17,895,697 |
671,758 |
12 |
206–209, 212 |
Other bone and musculoskeletal disease |
9,667,717 |
438,216 |
28 |
8,630,869 |
432,237 |
24 |
210–211 |
Systemic lupus and connective tissues disorders |
18,869,533 |
695,706 |
18 |
14,625,583 |
592,138 |
19 |
213–217 |
Congenital anomalies |
2,017,420 |
174,932 |
49 |
1,656,071 |
155,477 |
49 |
225–236, 239, 240, 244 |
Trauma-related disorders |
45,575,137 |
1,297,478 |
7 |
33,140,004 |
1,075,738 |
6 |
241–243 |
Poisoning by medical and non-medical substances |
2,914,645 |
222,170 |
44 |
2,177,129 |
186,994 |
47 |
253 |
Allergic reactions |
8,230,755 |
427,283 |
30 |
6,624,015 |
365,856 |
29 |
650–670 |
Mental disorders |
47,879,960 |
1,426,609 |
6 |
37,799,317 |
1,225,226 |
4 |
^top
Analytic
Considerations
Quality of household reported information
MEPS condition information is reported by a household respondent and consequently
subject to limitations in detail and accuracy. In general, conditions that are
salient, painful, require hospitalization, require ongoing treatment, have
specific recognizable treatment, alter lifestyle and/or affect daily life tend
to be more accurately reported by household respondents (Machlin et. al, 2009).
Moreover, research has suggested that the agreement between conditions reported
by household respondents and medical providers is weak for very specific
conditions, but improves as condition categories are expanded to include
broader ranges of conditions (Cox and Cohen, 1985). Consequently, the Clinical
Classification Codes (varname=CCCODEX)
generated by CCS, which aggregate somewhat similar ICD-9-CM conditions into
broad but clinically meaningful categories, are provided for analysts on the
Conditions file.
Prevalence
estimation limitations
As described earlier, medical conditions for MEPS sample persons are identified if
reported as a general problem, associated with medical care events, or as the reason
for missing school or work, or for spending days in bed during the year. When
analyzing MEPS condition data, it is important to consider that persons may
have conditions that are not captured in any of these sections so MEPS
condition data cannot be regarded as completely exhaustive. Moreover, the
household respondent reporting for other household members may not be fully aware
of problematic conditions for those persons (particularly those not associated
with medical events) and also may not be aware of some of their own conditions.
Consequently, estimates of condition prevalence in the population during the
year based on MEPS should be undertaken with caution and the quality of such
estimates likely varies substantially by type of condition.
To avoid some of the problems associated with estimating condition prevalence, an
option for MEPS analysts is to focus on “treated prevalence” in which
conditions are ascribed to persons only if they are reported as associated with
medical events in the survey. This approach has the advantages of tying the
analysis directly to MEPS utilization and expenditure data, which are key
components of the survey, and reducing the risk that the estimates or analysis
will be misconstrued as reflecting “true” prevalence. Nonetheless, “treated
prevalence” estimates are also subject to underestimation to the extent that
medical events and associated conditions are underreported by respondents. It
should also be considered that treated prevalence estimates
from MEPS are likely to better reflect true prevalence for conditions that are
salient and require ongoing treatment. For example, MEPS is commonly used to
produce estimates of treated prevalence and expenditures for chronic conditions. The AHRQ Healthcare
Utilization Project Chronic Condition Indicator (CCI) (http://www.hcup-us.ahrq.gov/toolssoftware/chronic/chronic.jsp) tool provides a method for identifying chronic conditions in MEPS.
^top
Summary
This
document uses 2008 MEPS data to describe the types, sources, and limitations of
condition information available from the survey. MEPS condition information is
household reported and consequently subject to limitations in detail and accuracy. Household respondents are asked open-ended questions about MEPS
sample persons’ medical conditions in the following sections of the
questionnaire: 1) Condition Enumeration (CE), 2) Medical Events (MV, ER, OP, HS,
PM, and HH) and 3) Disability Days (DD) sections. A particular condition for an
individual may be reported in all, some, or none of these sections.
Estimates
of condition prevalence in the population based on MEPS should be undertaken
with caution and the quality of such estimates likely varies substantially by
type of condition. Most conditions are identified in MEPS as a result of their
association with medical events reported by the household respondent. To avoid some of
the problems in estimating total population condition prevalence, MEPS analysts
may choose to focus on “treated prevalence” by ascribing conditions to persons only
when reported as associated with medical events in the survey. This approach
ties the analysis directly to MEPS utilization and expenditure data which are
key components of the survey.
^top
References
Cox
B., Cohen S. A Comparison of Household and Medical Provider Reports of Medical Conditions.
In: Cox B., Cohen S., eds. Methodological Issues for Health Care Surveys.
New York, NY: Marcel Dekker Inc.; 1985: 150–189.
Machlin
S., Cohen J., Elixhauser A., et. al. Sensitivity of Household Reported Medical
Conditions in the Medical Expenditure Panel Survey. Medical Care 2009;
47: 618–625.
^top
Appendix. MEPS CAPI Questions Ascertaining Medical Conditions
I. Condition
Enumeration Section
CE04
====
Between (START DATE)
and (END DATE), did (PERSON) have any physical or mental health problems,
accidents, or injuries?} [Please include all of (PERSON)’s conditions, accidents, or injuries regardless of whether (PERSON)
saw a medical provider, received treatment, or took medications {since (START
DATE)/between (START DATE) and (END DATE)}. {Also include health problems that
may have been mentioned during a previous interview, but have also bothered
(PERSON) {since (START DATE)/between (START DATE) and (END DATE)}.}]
CE05
====
What did
(PERSON) have?
PROBE: Did (PERSON)
have any other health problems, accidents, or injuries?
II. Medical
Events Sections
Medical Provider Visits
MV08
=====
Was this
visit related to any specific health condition or were any conditions
discovered during this visit?
MV09
=====
What
conditions were discovered or led (PERSON) to make this {visit/telephone call}?
PROBE: Any other
condition?
Emergency Room
ER03
====
Was this
visit related to any specific health condition or were any conditions
discovered during this visit?
ER04
====
What
conditions were discovered or led (PERSON) to make this visit?
PROBE: Any other
condition?
Home Health
HH05
=====
What health
condition led (PERSON) to receive home health care services from {someone from}
(PROVIDER) during (VISIT MONTH)?
PROBE: Any other health condition?
Hospital Stay
HS03
====
Was this
hospital stay related to any specific health condition or were any conditions
discovered during this hospital stay?
HS04
====
What
conditions were discovered or led (PERSON) to enter the hospital?
PROBE: Any other
condition?
Outpatient Department
OP08
====
Was this
{visit/telephone call} related to any specific health condition or were any
conditions discovered during this {visit/telephone call}?
OP09
====
What
conditions were discovered or led (PERSON) to make this {visit/telephone call}?
PROBE: Any other
condition?
Prescribed Medicines
PMO8
=====
Is
(MEDICINE) used for a specific health problem?
PMO9
=====
What health
problem is (MEDICINE) prescribed for?
PROBE: Any other
health problems?
III. Disability Days Section
The next questions
ask about time when (PERSON) may have missed a half day or more from work or
school or spent a half day or more in bed
{since (START DATE)/between (START DATE) and (END DATE)}. In answering these
questions, please include any time when this occurred because of (PERSON)’s
physical illness or injury, or a mental or emotional problem such as stress or depression.
DD02
=====
Let's start with
work. {Including the time (PERSON) (were/was) in {the hospital} {and} {the
long-term care facility}, how/How} many days did (PERSON) miss a half day or more from work {since (START DATE)/between (START
DATE) and (END DATE)}? Please do not include work around the house.
PROBE: Include any
time when a half day or more was missed because of a physical illness or
injury, or a mental or emotional problem.
DD03
=====
What are
the health problems that caused (PERSON) to miss work on those days?
PROBE: Any
other health problems?
DD04
=====
Of those days, how
many did (PERSON) stay in bed for a half day or more?
DD05
=====
Let's talk about
school (and day care). {Including the time (PERSON) (were/was) in {the
hospital} {and} {the long-term care facility}, how/How}
many days did (PERSON) miss a half day or more of school (or day care) {since
(START DATE)/between (START DATE) and (END DATE)}?
PROBE: Include any
time when a half day or more of school (or day care) was missed because of a
physical illness or injury, or a mental or emotional problem.
DD06
=====
What are
the health problems that caused (PERSON) to miss school on those days?
PROBE: Any
other health problems?
DD07
=====
Of those days, how
many did (PERSON) stay in bed a half day or more?
DD08
=====
{Besides the days in
bed you just told me about, how/How} many {additional} days did (PERSON) spend
a half day or more in bed {since (START DATE)/between (START DATE) and (END
DATE)} because of a physical illness or injury, or mental or emotional problem?
DD09
=====
What are
the health problems that caused (PERSON) to spend a half day or more in bed on
those days?
PROBE: Any
other health problems?
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