Medical Visit (MV) Section

BOX_00 (MV1000)

BOX_10 (MV1001)

MV10 (MV1015)

BLAISE NAME: MVSeeDoc

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER}-{DOC OR DEPT} {EVN-DT}

Question Text:

{Is {PROVIDER} a medical doctor?/Did {you/{PERSON}} see a medical doctor during this particular visit?}

HELP: F1

Responses: YES 1

NO 2

REFUSED RF

DON'T KNOW DK

Programmer If MV10 is coded ‘1’ (YES) and provider associated with event is a facility-provider, go to MV20.

If MV10 is coded ‘2’ (NO), ‘RF’ or ‘DK’ and provider associated with event is a facility-provider, go to MV30.

Otherwise, continue with BOX_20.

Display Instructions: Display ‘Is {PROVIDER} a medical doctor?’ if Provider linked to this event is flagged as a ‘person-provider’. Otherwise, display ‘Did {you/{PERSON}} see a medical doctor during this particular visit?’

BOX_20 (MV1017)

MV20 (MV1020)

BLAISE NAME: MVDocSpeclty

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER}-{DOC OR DEPT} {EVN-DT}

Question Text:

What was the doctor's specialty?

IF TALKED TO MORE THAN ONE DOCTOR, PROBE FOR MAIN PROVIDER.

Responses: ALLERGY/IMMUNOLOGY 1 BOX_30 (MV1030)

CARDIOLOGY (HEART) 3 BOX_30 (MV1030)

DERMATOLOGY (SKIN) 4 BOX_30 (MV1030)

ENDOCRINOLOGY/METABOLISM (DIABETES, THYROID) 5 BOX_30 (MV1030)

FAMILY PRACTICE 6 BOX_30 (MV1030)

GASTROENTEROLOGY 7 BOX_30 (MV1030)

GENERAL PRACTICE 8 BOX_30 (MV1030)

GENERAL SURGERY 9 BOX_30 (MV1030)

GYNECOLOGY/OBSTETRICS 11 BOX_30 (MV1030)

INTERNAL MEDICINE (INTERNIST) 14 BOX_30 (MV1030)

NEPHROLOGY (KIDNEYS) 15 BOX_30 (MV1030)

NEUROLOGY 16 BOX_30 (MV1030)

ONCOLOGY (TUMORS, CANCER) 18 BOX_30 (MV1030)

OPHTHALMOLOGY (EYES) 19 BOX_30 (MV1030)

ORTHOPEDICS 20 BOX_30 (MV1030)

OTORHINOLARYNGOLOGY (EAR, NOSE, THROAT) 22 BOX_30 (MV1030)

PEDIATRICIAN 24 BOX_30 (MV1030)

PSYCHIATRY/PSYCHIATRIST 28 BOX_30 (MV1030)

UROLOGY 33 BOX_30 (MV1030)

OTHER DR SPECIALTY 91 MV20LU (MV1023)

REFUSED RF BOX_30 (MV1030)

DON'T KNOW DK BOX_30 (MV1030)

Display Instructions:

MV20LU (MV1023)

BLAISE NAME: MVDocSpecltyLU

Context Header: {PERSON'S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER}-{DOC OR DEPT} {EVN-DT}

Question Text:

ENTER OTHER DOCTOR SPECIALTY.

TYPE THE FIRST 3 LETTERS OF THE SPECIALTY, THEN USE ARROW KEYS IF NEEDED TO LOCATE SPECIALTY, AND PRESS ENTER TO SELECT.

Responses: ALLERGY/IMMUNOLOGY 1

ANESTHESIOLOGY 2

CARDIOLOGY (HEART) 3

DERMATOLOGY (SKIN) 4

ENDOCRINOLOGY/METABOLISM (DIABETES, THYROID) 5

FAMILY PRACTICE 6

GASTROENTEROLOGY 7

GENERAL PRACTICE 8

GENERAL SURGERY 9

GERIATRICS (ELDERLY) 10

GYNECOLOGY/OBSTETRICS 11

HEMATOLOGY (BLOOD) 12

HOSPITAL RESIDENCE 13

INTERNAL MEDICINE (INTERNIST) 14

NEPHROLOGY (KIDNEYS) 15

NEUROLOGY 16

NUCLEAR MEDICINE 17

ONCOLOGY (TUMORS, CANCER) 18

OPHTHALMOLOGY (EYES) 19

ORTHOPEDICS 20

OSTEOPATHY (DO) 21

OTORHINOLARYNGOLOGY (EAR, NOSE, THROAT) 22

PATHOLOGY 23

PEDIATRICIAN 24

PHYSICAL MEDICINE/REHAB 25

PLASTIC SURGERY 26

PROCTOLOGY 27

PSYCHIATRY/PSYCHIATRIST 28

PULMONARY 29

RADIOLOGY 30

RHEUMATOLOGY (ARTHRITIS) 31

THORACIC SURGERY (CHEST) 32

UROLOGY 33

OTHER DR SPECIALTY 91

REFUSED RF

DON'T KNOW DK

Programmer Instructions: Go to BOX_30.

Responses listed are part of the provider specialty look-up file that works similar to a trigram search.

Browser window should be labeled “SELECT SPECIALTY”.

Response code numbers should be stored behind the scenes and not visible in the look-up window.

Display Instructions:

MV30 (MV1025)

BLAISE NAME: MVMPTp

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} - {DOC OR DEPT} {EVN-DT}

Question Text:

What type of medical person did {you/{PERSON}} talk to on {VISIT DATE}?

IF TALKED TO MORE THAN ONE MEDICAL PERSON, PROBE FOR MAIN PROVIDER.

HELP: F1

Responses: ACUPUNCTURIST 1 BOX_30 (MV1030)

CHIROPRACTOR 2 BOX_30 (MV1030)

DENTIST/DENTAL CARE PERSON 3 BOX_30 (MV1030)

HOMEOPATHIC/NATUROPATHIC/HERBALIST/OTHER ALTERNATIVE/COMPLEMENTARY CARE PROVIDER 4 BOX_30 (MV1030)

MASSAGE THERAPIST 5 BOX_30 (MV1030)

MENTAL HEALTH COUNSELOR/MARITAL OR FAMILY THERAPIST 6 BOX_30 (MV1030)

MIDWIFE 7 BOX_30 (MV1030)

NURSE/NURSE PRACTITIONER 8 BOX_30 (MV1030)

OPTOMETRIST 9 BOX_30 (MV1030)

PHYSICAL/OCCUPATIONAL THERAPIST 10 BOX_30 (MV1030)

PHYSICIAN'S ASSISTANT 11 BOX_30 (MV1030)

PODIATRIST 12 BOX_30 (MV1030)

PSYCHOLOGIST 13 BOX_30 (MV1030)

SOCIAL WORKER 14 BOX_30 (MV1030)

TECHNICIAN 15 BOX_30 (MV1030)

OTHER 91 BOX_30 (MV1030)

REFUSED RF BOX_30 (MV1030)

DON'T KNOW DK BOX_30 (MV1030)

Display Instructions:

BOX_30 (MV1030)

MV40 (MV1035)

BLAISE NAME: MVDocLoctn

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} - {DOC OR DEPT} {EVN-DT}

Question Text:

TYPE OF PERSON HAD CONTACT: {MEDICAL PERSON TYPE FROM MV30}

CODE WITHOUT ASKING IF OBVIOUS. OTHERWISE, ASK:

Do any medical doctors work at {the same location as {PROVIDER}/{PROVIDER}}?

HELP: F1

Responses: YES 1 MV50 (MV1040)

NO 2 MV50 (MV1040)

REFUSED RF MV50 (MV1040)

DON'T KNOW DK MV50 (MV1040)

Display Instructions: Display ‘the same location as {PROVIDER}’ if provider is flagged as ‘PERSON-TYPE-PROVIDER’. Display ‘{PROVIDER}’ if provider is flagged as ‘FACILITY-PROVIDER’.

For ‘MEDICAL PERSON TYPE FROM MV30’, display the following text for each code selected at MV30 (regardless if MV30 was collected for this RU member or in a previous round) (Provider[I]. MVMPTp):

Code ‘1’= ACUPUNCTURIST

Code ‘2’ = CHIROPRACTOR

Code ‘3’ = DENTIST/DENTAL CARE PERSON

Code ‘4’= HOMEOPATHIC/NATUROPATHIC/HERBALIST/ OTHER ALTERNATIVE/COMPLEMENTARY CARE PROVIDER

Code ‘5’= MASSAGE THERAPIST

Code ‘6’= MENTAL HEALTH COUNSELOR/MARITAL OR FAMILY THERAPIST

Code ‘7’ = MIDWIFE

Code ‘8’ = NURSE/NURSE PRACTITIONER

Code ‘9’ = OPTOMETRIST

Code ‘10’ = PHYSICAL’/ OCCUPATIONAL THERAPIST

Code ‘11’ = PHYSICIAN’S ASSISTANT

Code ‘12’ = PODIATRIST

Code ‘13’= PSYCHOLOGIST

Code ‘14’= SOCIAL WORKER

Code ‘15’= TECHNICIAN

Code ‘91’= OTHER

Code ‘RF’= REFUSED PROVIDER TYPE

Code ‘DK’= DON’T KNOW PROVIDER TYPE

MV50 (MV1040)

BLAISE NAME: MVVstCat

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} - {DOC OR DEPT} {EVN-DT}

Question Text:

&MV-1.

Please look at card MV-1 and tell me which category best describes the care {you/{PERSON}} received during the visit to { {DOC OR DEPT} at} {PROVIDER} on {VISIT DATE}.

HELP: F1

Responses: GENERAL CHECKUP 1 MV60 (MV1045)

DIAGNOSIS OR TREATMENT 2 MV60 (MV1045)

EMERGENCY (E.G., ACCIDENT OR INJURY) 3 MV60 (MV1045)

PSYCHOTHERAPY OR MENTAL HEALTH COUNSELING 4 MV60 (MV1045)

FOLLOW-UP OR POST-OPERATIVE VISIT 5 MV60 (MV1045)

IMMUNIZATIONS OR SHOTS 6 MV60 (MV1045)

VISION EXAM 7 MV60 (MV1045)

{PREGNANCY-RELATED (INCLUDING PRENATAL CARE AND DELIVERY)} 8 MV60 (MV1045)

{WELL CHILD EXAM} 9 MV60 (MV1045)

LASER EYE SURGERY 10 MV60 (MV1045)

OTHER 91 MV60 (MV1045)

REFUSED RF MV60 (MV1045)

DON'T KNOW DK MV60 (MV1045)

Display Instructions: Display response option ‘8’ (PREGNANCY-RELATED (INCLUDING PRENATAL CARE AND DELIVERY)) if person is female and age 15 to 55 inclusive (or age categories 3 to 8). Otherwise, use a null display.

Display response option ‘9’ (WELL CHILD EXAM) if PERSON IS < 7 YEARS OLD (OR AGE CATEGORIES 1 THROUGH 3). Otherwise, use a null display.

Display ‘{DOC OR DEPT} at’ if PROVIDER linked to this event is flagged as a facility provider and there a doctor or department linked to this specific event. Otherwise, use a null display.

MV60 (MV1045)

BLAISE NAME: MVSpecCond

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} - {DOC OR DEPT} {EVN-DT}

Question Text:

{Other than {your/his/her} {general checkup/well child exam}, was/Was} this visit related to any specific health condition or were any conditions discovered during this visit?

HELP:F1

Responses: YES 1 MV70 (MV1050)

NO 2 MV80 (MV1055)

REFUSED RF MV80 (MV1055)

DON'T KNOW DK MV80 (MV1055)

Display Instructions: Display ‘Other than {your/his/her} {general checkup/well child exam}, was’ if MV50 was coded ‘1’ (GENERAL CHECKUP) OR ‘9’ (WELL CHILD EXAM). Otherwise, display ‘Was’.

Display ‘general checkup’ if MV50 was coded ‘1’ (GENERAL CHECKUP). Display ‘well child exam’ if MV50 was coded ‘9’ (WELL CHILD EXAM).

MV70 (MV1050)

BLAISE NAME: MVCondRoster

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} - {DOC OR DEPT} {EVN-DT}

Question Text:

What conditions were discovered or led {you/ {PERSON}} to make this visit?

PROBE: Any other condition?

ENTER ALL THAT APPLY.

CTRL-A: ADD

CTRL-E: EDIT

CTRL-D: DELETE

HELP:F1

Responses: {MEDICAL CONDITION} 1 1 MV80 (MV1055)

{MEDICAL CONDITION} 2 2 MV80 (MV1055)

{MEDICAL CONDITION} 3 3 MV80 (MV1055)

{MEDICAL CONDITION} 4 4 MV80 (MV1055)

{MEDICAL CONDITION}N 5 MV80 (MV1055)

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:

Display the Person-Medical-Conditions-Roster for selection and addition of one or many medical condition (s) associated with this event. Display name of medical condition (COND.CONDNAM)

Roster filter:

Display all conditions on person's roster; no filter.

MV80 (MV1055)

BLAISE NAME: MVSurgProc

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} - {DOC OR DEPT} {EVN-DT}

Question Text:

Was a surgical procedure performed on {you/{PERSON}} during this visit?

HELP: F1

Responses: YES 1 MV90 (MV1070)

NO 2 MV90 (MV1070)

REFUSED RF MV90 (MV1070)

DON'T KNOW DK MV90 (MV1070)

Display Instructions:

MV90 (MV1070)

BLAISE NAME: MVSvcTp

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE

PROVIDER} - {DOC OR DEPT {EVN-DT}

Question Text:

&MV-2.

Looking at card MV-2, which of these services, if any, did {you/{PERSON}} have during this visit?

ENTER ALL THAT APPLY.

HELP: F1

Responses: LABORATORY TESTS 1 MV100 (MV1075)

SONOGRAM OR ULTRASOUND 2 MV110 (MV1080)

X-RAYS 3 MV110 (MV1080)

MAMMOGRAM 4 MV110 (MV1080)

MRI OR CATSCAN 5 MV110 (MV1080)

EKG, ECG, OR EEG 6 MV110 (MV1080)

VACCINATION 7 MV110 (MV1080)

NONE OF THESE SERVICES RECEIVED 95 MV110 (MV1080)

REFUSED RF MV110 (MV1080)

DON'T KNOW DK MV110 (MV1080)

Programmer Instructions: Soft check:

If MV90 (MVSvcTp) is coded '4' (MAMMOGRAM) and person being asked about is male or is female and < or = 17 years of age (or age categories 1-3), display the following message: "UNLIKELY RESPONSE FOR {MALES/CHILDREN 17 AND YOUNGER}. VERIFY AND RE-ENTER."

Display 'MALES' in error message if person being asked about is a male > 17 years of age (or age categories 4 through 9). Display 'CHILDREN 17 AND YOUNGER' in the error message if person being asked about is male or female and < or = 17 years of age (or age categories 1-3).

Allow code '95' (NONE OF THESE SERVICES RECEIVED), 'RF' (REFUSED) and 'DK' (DON'T KNOW) alone only. These responses may not be selected with any other response.

'NONE OF THESE SERVICES RECEIVED' is not displayed on show card.

Hard check:

Edit: If MV90 (MVSvcTp) is coded '95' (NONE OF THESE SERVICES RECEIVED), no other treatment categories can be coded. If interviewer selects another code with 'NONE OF THESE SERVICES', display the following message: "NONE OF THESE SERVICES RECEIVED CANNOT BE SELECTED WITH OTHER OPTIONS. VERIFY AND RE-ENTER."

Display Instructions:

MV100 (MV1075)

BLAISE NAME: WhereLabTest

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER}-{DOC OR DEPT} {EVN-DT}

Question Text:

Did {you/{PERSON}} receive the lab tests at {{PROVIDER/{PROVIDER}’s office}} or somewhere else?

Responses: THIS PROVIDER 1 MV110 (MV1080)

SOMEWHERE ELSE 2 MV110 (MV1080)

REFUSED RF MV110 (MV1080)

DON'T KNOW DK MV110 (MV1080)

Programmer Instructions:NOTE: CAPI will present a follow-up question to determine whether the separate lab event has already been recorded whenever MV100 is coded ‘2’ (SOMEWHERE ELSE).

Display Instructions: Display ‘{PROVIDER}’ if provider associated with this event is a facility provider. Otherwise, display ‘{PROVIDER}’s office.’

MV110 (MV1080)

BLAISE NAME: MVPmed

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} - {DOC OR DEPT} {EVN-DT}

Question Text:

During this visit, were any medicines prescribed for {you/{PERSON}}? Please include only prescriptions which were filled.

HELP: F1

Responses: YES 1 MV120 (MV1085)

NO 2 BOX_40 (MV1095)

REFUSED RF BOX_40 (MV1095)

DON'T KNOW DK BOX_40 (MV1095)

Display Instructions:

MV120 (MV1085)

BLAISE NAME: MVPmedRoster

Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} {NAME OF MEDICAL CARE PROVIDER} - {DOC OR DEPT} {EVN-DT}

Question Text:

Please tell me the names of the prescriptions from this visit that were filled.

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

ENTER ALL THAT APPLY.

CTRL-A: ADD

CTRL-E: EDIT

CTRL-D: DELETE

Responses: {PRESCRIBED MEDICINE}1 1 BOX_40 (MV1095)

{PRESCRIBED MEDICINE}2 2 BOX_40 (MV1095)

{PRESCRIBED MEDICINE}3 3 BOX_40 (MV1095)

{PRESCRIBED MEDICINE}4 4 BOX_40 (MV1095)

{PRESCRIBED MEDICINE}N 5 BOX_40 (MV1095)

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 MV120 for this event)

Display Instructions: Roster 3- Add/Edit/Delete Allowed

Roster definition:

This item displays the Person’s-Prescription-Medicines-Roster for selection. Display name of prescribed medicine (DRUG.DRUGNAME)

Roster filter:

Display all medicines in person's roster; no filter.

BOX_40 (MV1095)

BOX_50 (MV1100)

MV130 (MV1105)

BLAISE NAME: MVOthSameCond

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

Question Text:

Earlier I recorded that {you/{PERSON}} had some other visits to {PROVIDER}. {Were any of these visits related to {your/his/her} {PERSON’S MV MEDICAL CONDITION}?/Were any of the other visits also for {your/his/her} {PERSON’S MV MEDICAL CONDITION} or {PERSON’S MV MEDICAL CONDITION} {or {PERSON’S MV MEDICAL CONDITION}}?/ Were any of the other visits also for one of these conditions (READ CONDITIONS BELOW):}

{CONDITIONS

{PERSON'S MV MEDICAL CONDITION}1

{PERSON'S MV MEDICAL CONDITION}2

{PERSON'S MV MEDICAL CONDITION}3

{PERSON'S MV MEDICAL CONDITION}4

{PERSON'S MV MEDICAL CONDITION}N}

Responses: YES 1 MV140 (MV1115)

NO 2 BOX_60 (MV1125)

REFUSED RF BOX_60 (MV1125)

DON'T KNOW DK BOX_60 (MV1125)

Display Instructions: {DOC OR DEPT} should not display in context header.

Display ‘Were any of these visits related to {your/his/her} {PERSON’S MV MEDICAL CONDITION}?’ if only one condition selected or added to Person’s-Medical-Conditions-Roster at MV70. Display ‘Were any of the other visits also for {your/his/her} {PERSON’S MV MEDICAL CONDITION} or {PERSON’S MV MEDICAL CONDITION} {or {PERSON’S MV MEDICAL CONDITION}}?’ if exactly 2 or 3 conditions selected or added to Person’s-Medical-Conditions-Roster at MV70. Otherwise, display ‘Were any of the other visits also for one of these conditions (READ CONDITIONS BELOW):”

Display ‘or {PERSON’S MV MEDICAL CONDITION’ if exactly 3 conditions selected or added to Person’s-Medical-Conditions-Roster at MV70. Otherwise, use a null display.

For ‘PERSON’S MV MEDICAL CONDITION’ display the condition selected from or added to Person’s-Medical-Conditions-Roster at MV70.

Display the header ‘CONDITIONS’ and the list of conditions if more than three conditions selected or added to Person’s-Medical-Conditions-Roster at MV70. Otherwise, use a null display. For ‘PERSON’S MV MEDICAL CONDITION’, display all conditions selected from or added to Person’s-Medical-Conditions-Roster at MV70.

MV140 (MV1115)

BLAISE NAME: MVRepVstRoster

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

Question Text:

{Which of the following visits were also for {your/{PERSON}’s} {PERSON’S MV MEDICAL CONDITION} {{or {your/his/her}/,} {PERSON’S MV MEDICAL CONDITION}} {or {your/his/her} {PERSON’S MV MEDICAL CONDITION}}?/ Which of the following visits were also for one of these conditions (READ CONDITIONS BELOW) ?}

PROBE: Any other visits for the same condition?

ENTER ALL THAT APPLY.

{CONDITIONS

{PERSON'S MV MEDICAL CONDITION}1

{PERSON'S MV MEDICAL CONDITION}2

{PERSON'S MV MEDICAL CONDITION}3

{PERSON'S MV MEDICAL CONDITION}4

{PERSON'S MV MEDICAL CONDITION}N}

Responses: {SELECT ALL EVENTS} 0 MV150 (MV1120)

{MONTH,DAY,YEAR} - {DOC OR DEPT}1 1 MV150 (MV1120)

{MONTH,DAY,YEAR} - {DOC OR DEPT}2 2 MV150 (MV1120)

{MONTH,DAY,YEAR} - {DOC OR DEPT}3 3 MV150 (MV1120)

{MONTH,DAY,YEAR} - {DOC OR DEPT}4 4 MV150 (MV1120)

{MONTH,DAY,YEAR} - {DOC OR DEPT}N 5 MV150 (MV1120)

Programmer Instructions: If coded '0' SELECT ALL EVENTS, CAPI should automatically select all of the events displayed on the roster and flag as being part of the repeat visit group.

Flag each visit selected at MV140 as a repeat visit related to the event being asked about.

(NOTE: The event being cycled on through this MV section administration is the “stem” repeat visit. The events selected at MV140 are the “leaves”. The event driver (ED) section will not serve these repeat visits for the MV section.)

Assign next repeat visit number at the household level. (NOTE: Each repeat visit grouping, whether OP, MV, or HH is assigned this number at a household level. The number will start over every round.)

Roster behavior:

1. Multiple select allowed.

Display Instructions: {DOC OR DEPT} should not display in context header.

Roster 2- No Add/Edit/Delete

Roster definition:

This item displays all medical events (dates) on person's medical- events-roster for selection.

Display event begin date (EVNT.EVNTBEGM,EVNT.EVNTBEGD,EVNT.EVNTBEGY)

Roster filter:

Display only those event with the following characteristics.

1. Event was created this round.
   
   
2. Event has not been processed in utilization.
   
   
3. Event has event type ‘MV’.
   
   
4. Event is associated with the same provider as the event being asked about (regardless of the doctor or department linked to the specific event if provider is a facility provider).
   
   
5. Event is not already flagged as part of a flat fee bundle.

Next to each event date, display the doctor or department linked to that specific visit date.

Display ‘Which of the following visits were also for {your/{PERSON}’s} {PERSON’S MV MEDICAL CONDITION} {{or {your/his/her}/,} {PERSON’S MV MEDICAL CONDITION}} {or {your/his/her} {PERSON’S MV MEDICAL CONDITION}}?’ if three or less conditions selected or added to Person’s-Medical-Conditions-Roster at MV70. Otherwise display, ‘Which of the following visits were also for one of these conditions (READ CONDITIONS BELOW)?’

Display ‘{or {your/his/her}/,} {PERSON’S MV MEDICAL CONDITION}’ if two or three conditions selected or added to Person’s-Medical-Conditions-Roster at MV70. Otherwise, use a null display.

Display “or {your/his/her}” if exactly two conditions selected or added to Person’s-Medical-Conditions-Roster at MV70. Otherwise, display ‘,’.

Display ‘or {your/his/her} {PERSON’S MV MEDICAL CONDITION}’ if exactly three conditions selected or added to Person’s-Medical-Conditions-Roster at MV70. Otherwise, use a null display.

For ‘PERSON’S MV MEDICAL CONDITION’ display the condition selected from or added to Person’s-Medical-Conditions-Roster AT MV70.

Display the header ‘CONDITIONS’ and the list of conditions if more than three conditions selected or added to Person’s-Medical-Conditions-Roster at MV70. Otherwise, use a null display. For ‘PERSON’S MV MEDICAL CONDITION’, display all conditions selected from or added to Person’s-Medical-Conditions-Roster at MV70.

For "MONTH,DAY,YEAR" in the response option area, display visit dates as "MON DD, YYYY".

Abbreviate the month name as three letters.

Display the response option '0' SELECT ALL EVENTS when there is more than one event to display on the roster, otherwise use a null display.

MV150 (MV1120

BLAISE NAME: MVEvntVstGrp

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

Question Text:

INTERVIEWER: RECORD ‘NAME OF REPEAT VISIT GROUP’ FOR EVENTS SELECTED IN PREVIOUS QUESTION:

Responses: 1 BOX_60 (MV1125)

Programmer Instructions: 'RF/DK not allowed'

Display Instructions: {DOC OR DEPT} should not display in context header.

BOX_60 (MV1125)

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