Hospital Stay (HS) Section

BOX_00 (HS1000)

HS10 (HS1002)

BLAISE NAME: ConfIPStay

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

I have recorded that {you/{PERSON}} {{were/was} admitted to and discharged from {PROVIDER} on the same day./stayed in {PROVIDER} {XX} {night/nights}}. Is that correct?

Responses: YES 1 HS30 (HS1015)

NO 2 HS20 (HS1005)

REFUSED RF HS30 (HS1015)

DON’T KNOW DK HS30 (HS1015)

Display Instructions: Display ‘were admitted to and discharged from {PROVIDER} on the same day.’ if the reported admit and discharge dates for this stay were the same day. Otherwise, display ‘STAYED IN {PROVIDER} {XX} {NIGHT/NIGHTS}.’

For “XX” display the number of nights in the hospital using the reported admit and discharge dates for this stay.

Display ‘NIGHT’ if number of nights in the hospital is equal to 1. Otherwise, display ‘nights’.

HS20 (HS1005)

BLAISE NAME: NumNight

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

How many nights did {you/{PERSON}} stay in {PROVIDER}?

ENTER NIGHTS.

Responses: 1 HS30 (HS1015)

REFUSED RF HS30 (HS1015)

DON’T KNOW DK HS30 (HS1015)

Programmer Instructions: Soft range 1-30.

Range check:

If number entered is above 30, display the following message: “A HOSPITAL STAY LONGER THAN 30 NIGHTS IS UNLIKELY. VERIFY AND RE-ENTER IF NEEDED.”

If number entered is less than 1, display the following message: “EARLIER RU MEMBER SAID THEY HAD A HOSPITAL STAY OF AT LEAST ONE NIGHT. VERIFY AND RE-ENTER. OR GO BACK TO HS10 (ConflPStay)”

CAPI should give the option to return to HS10 to change their response on this message screen.

Display Instructions:

HS30 (HS1015)

BLAISE NAME: IPRelCond

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

Was this hospital stay related to any specific health condition or were any conditions discovered during this stay?

Responses: YES 1 HS40 (HS1020)

NO 2 HS50 (HS1025)

REFUSED RF HS50 (HS1025)

DON’T KNOW DK HS50 (HS1025)

Display Instructions:

HS40 (HS1020)

BLAISE NAME: IPCondRoster

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

What conditions were discovered or led {you/{PERSON}} to enter the hospital?

PROBE: Any other condition?

ENTER ALL THAT APPLY.

CTRL-A: ADD

CTRL-E: EDIT

CTRL-D: DELETE

HELP: F1

Responses: {MEDICAL CONDITION} 1 1 HS50 (HS1025)

{MEDICAL CONDITION} 2 2 HS50 (HS1025)

{MEDICAL CONDITION} 3 3 HS50 (HS1025)

{MEDICAL CONDITION} 4 4 HS50 (HS1025)

{MEDICAL CONDITION}N 5 HS50 (HS1025)

Programmer Instructions: Roster behavior:

1. Multiple select allowed.
   
   
2. Multiple add allowed.
   
   
3. Limited delete allowed. Interviewer may delete a condition added at this item until CAPI creates the link between this condition and the event. The link is created when the collection of utilization and/or charge/payment data is complete.
   
   
4. Limited edit allowed. Interviewer may edit a condition name newly added at this item until CAPI creates the link between this condition and the event. The link is created when the collection of utilization and/or charge/payment data is complete.

Display Instructions: Roster 3 - add/edit/delete allowed

Roster definition:

This item displays person-medical-conditions-roster for selection and addition of one or many medical conditions associated with this event. Display name of medical condition (COND.CONDNAM)

Roster filter:

Display all conditions on person's roster; display all.

HS50 (HS1025)

BLAISE NAME: ResnHosp

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

&HS-1.

Please look at card HS-1 and tell me which category best describes the reason {you/{PERSON}} entered {PROVIDER} on {ADMIT DATE}.

IF NECESSARY, PROBE: What was the main reason {you/he/she} entered {PROVIDER}?

HELP: F1

Responses: OPERATION OR SURGICAL PROCEDURE 1 HS80 (HS1035)

TREATMENT OR THERAPY, NOT INCLUDING SURGERY 2 HS70 (HS1030)

DIAGNOSTIC TESTS ONLY 3 HS70 (HS1030)

{GIVE BIRTH TO A BABY - NORMAL OR CAESAREAN SECTION (MOTHER)} 4

{TO BE BORN (BABY)} 5 HS70 (HS1030)

{PREGNANCY-RELATED COMPLICATIONS} 6 HS70 (HS1030)

OTHER 91 HS70 (HS1030)

REFUSED RF HS70 (HS1030)

DON’T KNOW DK HS70 (HS1030)

Programmer Instructions: If HS50 is coded ‘1’ (OPERATION OR SURGICAL PROCEDURE), auto code HS70 as ‘1’ (YES) by CAPI.

NOTE: CAPI will present a follow-up question to determine whether a hospital stay event for the baby/mother is present whenever HS50 is coded ‘4’ (GIVE BIRTH TO A BABY) or ‘5’ (TO BE BORN).

Display Instructions: Display response option ‘4’ (GIVE BIRTH TO A BABY) and response option ‘6’ (PREGNANCY-RELATED COMPLICATIONS) only if person is female and age 15 to 55 inclusive (or age categories 3 to 8). Otherwise, use a null display.

Display response option ‘5’ (TO BE BORN) only if person is < or = 1 year old (or age category 1).

Otherwise, use a null display.

HS70 (HS1030)

BLAISE NAME: IPSurgProc

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

Were any operations or surgical procedures performed on {you/{PERSON}} during this stay?

HELP: F1

Responses: YES 1 HS80 (HS1035)

NO 2 HS80 (HS1035)

REFUSED RF HS80 (HS1035)

DON’T KNOW DK HS80 (HS1035)

Display Instructions:

HS80 (HS1035)

BLAISE NAME: ICU

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

Did {you/{PERSON}} spend any time in an intensive or critical care unit (ICU) during this stay?

HELP: F1

Responses: YES 1 HS90 (HS1055)

NO 2 HS90 (HS1055)

REFUSED RF HS90 (HS1055)

DON’T KNOW DK HS90 (HS1055)

Display Instructions:

HS90 (HS1055)

BLAISE NAME: IPPmed

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

At the time {you/{PERSON}} {were/was} discharged, were any medicines prescribed for {you/him/her}? Please do not include medications received while {you/he/she} {were/was} a patient in the hospital.

HELP: F1

Responses: YES 1 HS100 (HS1060)

NO 2 BOX_10 (HS1065)

REFUSED RF BOX_10 (HS1065)

DON’T KNOW DK BOX_10 (HS1065)

Display Instructions:

HS100 (HS1060)

BLAISE NAME: IPPmedRoster

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER......} {ADM-DT}

{DIS-DT}

Question Text:

Please tell me the names of the prescribed medicines from this stay that were filled.

PROBE: Any other prescribed medicines from this stay that were filled?

ENTER ALL THAT APPLY.

CTRL-A: ADD

CTRL-E: EDIT

CTRL-D: DELETE

Responses: {PRESCRIBED MEDICINE}1 1 BOX_10 (HS1065)

{PRESCRIBED MEDICINE}2 2 BOX_10 (HS1065)

{PRESCRIBED MEDICINE}3 3 BOX_10 (HS1065)

{PRESCRIBED MEDICINE}4 4 BOX_10 (HS1065)

{PRESCRIBED MEDICINE}N 5 BOX_10 (HS1065)

Programmer Instructions: Roster behavior:

1. Multiple select allowed.
   
   
2. Multiple add allowed.
   
   
3. Limited delete allowed. Interviewer may delete a medicine added at this item until CAPI creates the link between this medicine and the event. The link is created when the collection of utilization and/or charge/payment data is complete.
   
   
4. Limited edit allowed. Interviewer may edit medicines added at this item until CAPI creates the link between this medicine and the event. The link is created when the collection of utilization and/or charge/payment data is complete.

NOTE: In order for the columns to display properly, 35 allowable characters for the medicines will be accepted for display on the roster.

When adding a medicine in the pop-up manipula, a maximum of 60 characters will be allowed.

When the CTRL-D or CTRL-E command is called, the pop-up manipula should display 60 characters for the medicine name.

General flag rules for medicines:

- Round medicine first created (by definition a medicine is selected the same time it is created)

- Question number medicine first created

- Round medicine selected

- Event medicine is linked to (however, this is known by virtue that the medicine was selected at HS100 for this event)

Display Instructions: Roster 3 - add/edit/delete allowed

Roster definition:

This item displays the Person’s-Prescribed-Medicines-Roster for selection and addition of prescribed medicines. Display name of prescribed medicine.

Roster filter:

Display all medicines on person’s roster; no filter.

BOX_10 (HS1065)

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