Access to Care (AC) SectionFall 2018 BOX_00 (AC1000) Route Details: 01 Box = BOX_10, BOX_20, BOX_30, BOX_40, BOX_50, BOX_60, BOX_70, BOX_80, BOX_90, BOX_100, BOX_110 02 Loop = LOOP_10, LOOP_20, LOOP_30 03 End Loop = END_LP10, END_LP20, ENDLP_30 04 Single Select = AC10, AC20, AC30, AC40, AC50, AC60, AC70, AC80, AC90, AC100, AC120, AC140, AC150, AC160, AC170, AC180, AC190, AC200, AC210, AC230, AC240, AC250 08 Multiple Select = AC110 10 Multiple Select with Fill in Answer Text = AC220 20 OS Text Field = AC80OS, AC90OS BOX_10 (AC1005) Route Details: The AC section is asked in rounds 2 and 4 only. If it is round 1, 3, or 5, continue to the next section. BOX_20 (AC1010) Route Details: Context header display instructions: display Person.FullName, Prov.LorpName, LPERSON.FULLNAME LOOP_10 (AC1015) Route Details: For each element in the RU-members-roster, ask AC10 - END_LP10. Loop definition: LOOP_10 collects the name of the usual source of care provider, if any, for each current RU member. This loop cycles on persons who meet the following conditions: -Person is a current RU member (included in person array) -Person is not deceased (PersRndStatus ≠Deceased) -Person is not institutionalized (PersRndStatus ≠ Institutionalized) AC10 (AC1020) BLAISE NAME: HaveUSC Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} Question Text: Is there a particular doctor's office, clinic, health center, or other place that {you/{PERSON}} usually {go/goes} if {you/he/she} {are/is} sick or {need/needs} advice about {your/his/her} health? HELP: F1 Responses: YES 1 AC30 (AC1030) NO 2 AC40 (AC1035) MORE THAN ONE PLACE 3 AC20 (AC1025) REFUSED RF END_LP10 (AC1120) DON'T KNOW DK END_LP10 (AC1120) Display Instructions: AC20 (AC1025) BLAISE NAME: GoFirst Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} Question Text: Would {you/{PERSON}} go to one of these places first or most often if {you/he/she} {are/is} sick? Responses: YES 1 AC30 (AC1030) NO 2 AC40 (AC1035) REFUSED RF END_LP10 (AC1120) DON'T KNOW DK END_LP10 (AC1120) Display Instructions: AC30 (AC1030) BLAISE NAME: USCLoctn Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} Question Text: Does the medical provider {you/{PERSON}} usually {see/sees} have his or her own practice that is not part of a group practice, health center, clinic, or other facility? Responses: OWN PRACTICE, NOT PART OF GROUP/FACILITY 1 BOX_30 (AC1036) PRACTICE IS ASSOCIATED WITH GROUP/FACILITY 2 BOX_30 (AC1036) REFUSED RF BOX_30 (AC1036) DON'T KNOW DK BOX_30 (AC1036) Display Instructions: Display 'see' if asking about the respondent. Otherwise, display 'sees' For response 1 "OWN PRACTICE, NOT PART OF GROUP/FACILITY", display the word "NOT" with an underline. AC40 (AC1035) BLAISE NAME: WhyNoUSC Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME} Question Text: What is the main reason {you/{PERSON}} {do/does} not have a usual source of health care? HELP: F1 Responses: SELDOM OR NEVER GETS SICK 1 END_LP10 (AC1120) RECENTLY MOVED INTO AREA 2 END_LP10 (AC1120) JUST CHANGED INSURANCE PLANS 3 END_LP10 (AC1120) NO HEALTH INSURANCE, OTHER INSURANCE RELATED REASON 4 END_LP10 (AC1120) DON'T KNOW WHERE TO GO FOR CARE 5 END_LP10 (AC1120) USUAL SOURCE OF MEDICAL CARE IN THIS AREA IS NO LONGER AVAILABLE 6 END_LP10 (AC1120) LIKES TO GO TO DIFFERENT PLACES FOR DIFFERENT HEALTH NEEDS 7 END_LP10 (AC1120) DON'T USE DOCTORS/TREAT MYSELF 8 END_LP10 (AC1120) COST OF MEDICAL CARE 9 END_LP10 (AC1120) OTHER REASON 91 END_LP10 (AC1120) REFUSED RF END_LP10 (AC1120) DON'T KNOW DK END_LP10 (AC1120) Display Instructions: BOX_30 (AC1036) Route Details: Ask the provider roster (PV) section. At the completion of the provider roster (PV) section, continue with BOX_40. BOX_40 (AC1055) Route Details: If provider added or selected at PV30LU is a person provider, that person provider will be considered the ‘USC (USUAL SOURCE OF CARE PROVIDER) PROVIDER’ for this person for this round. If provider added or selected at PV30LU is a facility provider and PV70=0, that facility provider will be considered the ‘USC (USUAL SOURCE OF CARE PROVIDER) PROVIDER’ for this person for this round. If provider added or selected at PV30LU is a facility provider and PV70 ≠ 0 or empty, the entry at PV70, in conjunction with the facility provider at PV30LU, will be the ‘(USUAL SOURCE OF CARE PROVIDER) PROVIDER’ for this person for this round. If the USC provider is a person provider, then the USC type is PERSON-TYPE PROVIDER. If the USC provider is a facility provider and PV70=0, then the USC type is a FACILITY-TYPE PROVIDER. If the USC provider is a facility provider and PV70≠0 or empty, then the USC type is a PERSON-IN-FACILITY-TYPE PROVIDER and the entry entered at PV70 will be considered the USC in conjunction with the facility provider selected or added at PV30LU. If USC provider selected at PV30LU is a FACILITY-TYPE PROVIDER or a PERSON-IN-FACILITY-TYPE PROVIDER and AC50 was not already asked for this USC provider in an earlier loop, or in round 2 if round 4 or if it’s round 4 and in round 2, this item was coded as missing (RF, DK), go to AC50. Otherwise, if USC provider selected at PV30LU is (a PERSON-TYPE PROVIDER) or (a FACILITY-TYPE PROVIDER or a PERSON IN FACILITY TYPE PROVIDER and AC50 has already been asked for this USC provider in an earlier loop, or in round 2 if round 4 (Preload.PlaceType)), go to AC60. AC50 (AC1060) BLAISE NAME: PlaceType Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: ASK IF NOT OBVIOUS. {Is {PROVIDER}/Does {PROVIDER} work at} a clinic in a hospital, a hospital outpatient department, an emergency room at a hospital, or some other kind of place? HELP: F1 Responses: HOSPITAL CLINIC OR OUTPATIENT DEPARTMENT 1 AC60 (AC1065) HOSPITAL EMERGENCY ROOM 2 AC60 (AC1065) OTHER KIND OF PLACE 3 AC60 (AC1065) REFUSED RF AC60 (AC1065) DON'T KNOW DK AC60 (AC1065) Programmer Instructions: Note: for questions AC50-AC120, the context header will always display the name of the USC provider entered at PV30LU for ‘NAME OF FACILITY’. Display the entry entered at PV70 for ‘NAME OF MEDICAL CARE PROVIDER’’ otherwise, use a null display. Display Instructions: Display ‘Is {PROVIDER}’ if USC provider is a ‘FACILITY-TYPE- PROVIDER’. Display ‘Does {PROVIDER} work at’ if USC provider is a ‘PERSON IN FACILITY-TYPE-PROVIDER’ and display the entry selected or added at PV70 for ‘PROVIDER’ AC60 (AC1065) BLAISE NAME: TimeProv Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: How long does it usually take {you/{PERSON}} to get to {PROVIDER}? Responses: LESS THAN 15 MINUTES 1 BOX_50 (AC1070) 16 TO 30 MINUTES 2 BOX_50 (AC1070) 31 TO 60 MINUTES (1 HOUR) 3 BOX_50 (AC1070) 61 TO 90 MINUTES 4 BOX_50 (AC1070) 91 TO 120 MINUTES (2 HOURS) 5 BOX_50 (AC1070) MORE THAN 120 MINUTES (2 HOURS) 6 BOX_50 (AC1070) REFUSED RF BOX_50 (AC1070) DON'T KNOW DK BOX_50 (AC1070) Display Instructions: BOX_50 (AC1070) Route Details: If this USC provider is a ‘PERSON-TYPE-PROVIDER’ OR 'PERSON IN FACILITY-TYPE-PROVIDER' and
Otherwise, go to BOX_60. AC70 (AC1075) BLAISE NAME: ProvDoc Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: Is {PROVIDER} a medical doctor? HELP: F1 Responses: YES 1 AC90 (AC1090) NO 2 AC80 (AC1080) REFUSED RF AC100 (AC1100) DON'T KNOW DK AC100 (AC1100) Display Instructions: AC80 (AC1080) BLAISE NAME: ProvOthType Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: Is {PROVIDER} a nurse, nurse practitioner, physician's assistant, midwife, or some other kind of person? SELECT 'CHIROPRACTOR' IF CHIROPRACTOR VOLUNTEERED AS TYPE OF MEDICAL PERSON. HELP: F1 Responses: NURSE 1 BOX_60 (AC1096) NURSE PRACTITIONER 2 BOX_60 (AC1096) PHYSICIAN'S ASSISTANT 3 BOX_60 (AC1096) MIDWIFE 4 BOX_60 (AC1096) CHIROPRACTOR 5 BOX_60 (AC1096) OTHER 91 AC80OS (AC1085) REFUSED RF BOX_60 (AC1096) DON'T KNOW DK BOX_60 (AC1096) Display Instructions: Display AC80 and AC80OS on the same form pane. AC80OS (AC1085) BLAISE NAME: ProvOthTypeOS Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: SPECIFY: OTHER TYPE Responses: 1 BOX_60 (AC1096) REFUSED RF BOX_60 (AC1096) DON'T KNOW DK BOX_60 (AC1096) Display Instructions: Display AC80 and AC80OS on the same form pane. AC90 (AC1090) BLAISE NAME: ProvSpeclt Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: What is {PROVIDER}'s specialty? Responses: GENERAL/FAMILY PRACTICE 1 BOX_60 (AC1096) INTERNAL MEDICINE 2 BOX_60 (AC1096) PEDIATRICS 3 BOX_60 (AC1096) OB/GYN 4 BOX_60 (AC1096) SURGERY 5 BOX_60 (AC1096) CHIROPRACTOR 6 BOX_60 (AC1096) CARDIOLOGIST 7 BOX_60 (AC1096) DOCTOR OF OSTEOPATHY 8 BOX_60 (AC1096) OTHER 91 AC90OS (AC1095) REFUSED RF BOX_60 (AC1096) DON'T KNOW DK BOX_60 (AC1096) Display Instructions: Display AC90 and AC90OS on the same form pane. AC90OS (AC1095) BLAISE NAME: ProvSpecltOS Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: SPECIFY: OTHER SPECIALTY. Responses: 1 BOX_60 (AC1096) REFUSED RF BOX_60 (AC1096) DON'T KNOW DK BOX_60 (AC1096) Display Instructions: Display AC90 and AC90OS on the same form pane. BOX_60 (AC1096) Route Details: If this USC provider is a 'PERSON-TYPE-PROVIDER' or 'PERSON IN FACILITY TYPE-PROVIDER' and [(AC100 not already answered this round for this same USC provider in an earlier cycle) or (if round 4 and Preload.ProvHispLat=DK, RF, or EMPTY (i.e., AC100 never asked in round 2, DK, or RF) for this same USC provider)], go to AC100. Otherwise, go to BOX_70. AC100 (AC1100) BLAISE NAME: ProvHispLat Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: Is {PROVIDER} Hispanic or Latino? Responses: YES 1 BOX_70 (AC1101) NO 2 BOX_70 (AC1101) REFUSED RF BOX_70 (AC1101) DON'T KNOW DK BOX_70 (AC1101) Display Instructions: BOX_70 (AC1101) Route Details: If this USC provider is a 'PERSON-TYPE-PROVIDER' or 'PERSON IN FACILITY TYPE-PROVIDER' and (AC110 not already answered this round for this same USC provider in an earlier cycle) or (if round 4 and Preload.AskProvRace=1 (YES) (i.e., AC110 never asked, or RF, DK in round 2) for this same USC provider)], go to AC110. Otherwise, go to BOX_80. AC110 (AC1110) BLAISE NAME: ProvRace Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: AC-1. What is {PROVIDER}'s race? ENTER ALL THAT APPLY. Responses: WHITE 1 BOX_80 (AC1111) BLACK/AFRICAN AMERICAN 2 BOX_80 (AC1111) ASIAN 3 BOX_80 (AC1111) INDIAN/NATIVE AMERICAN/ALASKA NATIVE 4 BOX_80 (AC1111) OTHER PACIFIC ISLANDER 5 BOX_80 (AC1111) SOME OTHER RACE 91 BOX_80 (AC1111) REFUSED RF BOX_80 (AC1111) DON'T KNOW DK BOX_80 (AC1111) Display Instructions: BOX_80 (AC1111) Route Details: If this USC provider is a 'PERSON-TYPE-PROVIDER' or 'PERSON IN FACILITY TYPE-PROVIDER' and (AC120 not already answered this round for this same USC provider in an earlier cycle) or (if round 4 and Preload.ProvGender=DK, RF, or EMPTY (i.e., AC120 never asked in round2) for this same USC provider)], go to AC120. Otherwise, go to END_LP10. AC120 (AC1115) BLAISE NAME: ProvGender Context Header: {PERSON’S FIRST MIDDLE AND LAST NAME}{{NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: Is {PROVIDER} male or female? Responses: MALE 1 END_LP10 (AC1120) FEMALE 2 END_LP10 (AC1120) REFUSED RF END_LP10 (AC1120) DON'T KNOW DK END_LP10 (AC1120) Display Instructions: END_LP10 (AC1120) Route Details: Cycle on next person in the RU-members-roster who meets the conditions stated in the loop definition. If no other persons meet the stated conditions, end LOOP_10 and continue with BOX_90. BOX_90 (AC1121) Route Details: If at least one provider was selected or added as a ‘USC provider’ on the RU- medical-providers-roster, continue with LOOP_20. Otherwise, go to AC210. LOOP_20 (AC1130) Route Details: For each element in the RU-medical-providers-roster, ask AC140 - END_LP20. Loop definition: LOOP_20 collects detailed information on each unique usual source of care provider identified for this RU. This loop cycles on providers who meet the following condition: -Provider was selected or added as ‘USC provider’ during the current round for a current RU member. Note: if the USC provider being looped on is a 'PERSON IN FACILITY-TYPE-PROVIDER' the context header in LOOP_20 will display the name of facility selected or added at PV30LU. if the USC provider being looped on is a ‘FACILITY- TYPE- PROVIDER', the context header in LOOP_20 will display the facility-provider name. If the USC provider being looped on is ‘PERSON-TYPE PROVIDER’ the context header in LOOP_20 will display the person-provider name. For ‘PROVIDER’ in the question text, display the name of the facility if the USC type is a FACILITY TYPE PROVIDER, display the name of the person provider, if the USC type is a PERSON TYPE PROVIDER, and display the name entered at PV70, if the USC type is PERSON IN FACILITY TYPE PROVIDER. AC140 (AC1140) BLAISE NAME: PhoneDfclt Context Header: {NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: AC-2. The next few questions ask about the experience {{PERSON 1},} {PERSON 2},} {PERSON 3},} {PERSON 4},} {PERSON N},} {or their parents} {have had/has had} with {PROVIDER} . Please think about their overall experiences when answering the following questions. How difficult is it to contact {a medical person at} {PROVIDER} during regular business hours over the telephone about a health problem? Would you say it is very difficult, somewhat difficult, not too difficult, or not at all difficult? Responses: VERY DIFFICULT 1 SOMEWHAT DIFFICULT 2 NOT TOO DIFFICULT 3 NOT AT ALL DIFFICULT 4 REFUSED RF DON'T KNOW DK Programmer Instructions: If AC50 was coded ‘2’ (HOSPITAL EMERGENCY ROOM) for this USC provider, go to AC160. Otherwise, continue with AC150. Display Instructions: Display ‘a medical person at’ if USC provider being looped on is a ‘FACILITY-TYPE- PROVIDER’. Otherwise, use a null display. Display 'have had' if roster list displayed at the question text includes the respondent or includes more than 1 person. Otherwise, display 'has had'. Roster definition: Roster 1 - Report This item displays RU-members-roster for display. Display RU member’s first, middle, and last names (Person.FullName). Display “you” rather than the respondent’s name, when respondent’s name is included in the list. Separate each name with a comma and before the last RU member’s name display an “and”. Roster filter: Display all persons on the RU-members-roster who identified provider being asked about as person's USC provider for the current round. Display “or their parents” if all the RU members displayed in the roster are <=17 years old (or age category 1-3), otherwise, use a null display. AC150 (AC1145) BLAISE NAME: OffHours Context Header: {NAME OF MEDICAL CARE PROVIDER......}{NAME OF FACILITY} Question Text: Does {PROVIDER} have office hours at night or on weekends? Responses: YES 1 AC160 (AC1150) NO 2 AC160 (AC1150) REFUSED RF AC160 (AC1150) DON'T KNOW DK AC160 (AC1150) Display Instructions: AC160 (AC1150) BLAISE NAME: AfterHours Context Header: {NAME OF MEDICAL CARE PROVIDER.......}{NAME OF FACILITY} Question Text: AC-2. How difficult is it to contact {a medical person at} {PROVIDER} after their regular hours in case of urgent medical needs? Responses: VERY DIFFICULT 1 AC170 (AC1155) SOMEWHAT DIFFICULT 2 AC170 (AC1155) NOT TOO DIFFICULT 3 AC170 (AC1155) NOT AT ALL DIFFICULT 4 AC170 (AC1155) REFUSED RF AC170 (AC1155) DON'T KNOW DK AC170 (AC1155) Display Instructions: Display ‘a medical person at’ if USC provider being looped on is a 'FACILITY- TYPE- PROVIDER’. Otherwise, use a null display. AC170 (AC1155) BLAISE NAME: OthTrtmt Context Header: {NAME OF MEDICAL CARE PROVIDER......} {NAME OF FACILITY} Question Text: Does {someone at} {PROVIDER} usually ask about prescription medications and treatments other doctors may give Responses: YES 1 AC180 (AC1160) NO 2 AC180 (AC1160) REFUSED RF AC180 (AC1160) DON'T KNOW DK AC180 (AC1160) Display Instructions: Display ‘someone at’ if USC provider being looped on is a ‘FACILITY-TYPE- PROVIDER’. Otherwise, use a null display. AC180 (AC1160) BLAISE NAME: AskChoose Context Header: {NAME OF MEDICAL CARE PROVIDER.......} {NAME OF FACILITY} Question Text: AC-3. If there were a choice between treatments, how often would {a medical person at} {PROVIDER} ask {{PERSON 1},} {PERSON 2},} {PERSON 3},} {PERSON 4},}{PERSON N},} {or their parents} to help make the decision? Would you say never, sometimes, usually, or always? Responses: NEVER 1 AC190 (AC1165) SOMETIMES 2 AC190 (AC1165) USUALLY 3 AC190 (AC1165) ALWAYS 4 AC190 (AC1165) REFUSED RF AC190 (AC1165) DON'T KNOW DK AC190 (AC1165) Display Instructions: Roster definition: Roster 1 - Report This item displays RU-members-roster for display. Display RU member’s first, middle, and last names (Person.FullName). Display “you” rather than the respondent’s name, when respondent’s name is included in the list. Display reference person’s name, when the respondent is a proxy. Separate each name with a comma and before the last RU member’s name display an “and”. Roster filter: Display all persons on the RU-members-roster who identified provider being asked about as person's USC provider for the current round. Display “or their parents” if all the RU members displayed in the roster are <=17 years old (or age category 1-3), otherwise, use a null display. Display ‘a medical person at’ if USC provider being looped on is a ‘FACILITY- TYPE- PROVIDER’. Otherwise, use a null display. AC190 (AC1165) BLAISE NAME: ExplOpt Context Header: {NAME OF MEDICAL CARE PROVIDER.......} {NAME OF FACILITY} Question Text: Does {a medical person at} {PROVIDER} present and explain all options to {{PERSON 1},} {{PERSON 2},} {{PERSON 3},} {{PERSON 4},} {{and} PERSON N} {or their parents}? Responses: YES 1 BOX_100 (AC1166) NO 2 BOX_100 (AC1166) REFUSED RF BOX_100 (AC1166) DON'T KNOW DK BOX_100 (AC1166) Display Instructions: Roster definition: Roster 1 - Report This item displays RU-members-roster for display. Display RU member’s first, middle, and last names (Person.FullName). Display “you” rather than the respondent’s name, when respondent’s name is included in the list. Display reference person’s name, when the respondent is a proxy. Separate each name with a comma and before the last RU member’s name display an “and”. Roster filter: Display all persons on the RU-members-roster who identified provider being asked about as person's USC provider for the current round. Display “or their parents” if all the RU members displayed in the roster are <=17 years old (or age category 1-3), otherwise, use a null display. Display ‘a medical person at’ if USC provider being looped on is a ‘FACILITY- TYPE-PROVIDER’. BOX_100 (AC1166) Route Details: If at least one person who identified the USC provider currently being looped on as their USC provider AND RE1170_09 was coded ‘3’ (NOT WELL) or ‘4’ (NOT AT ALL) in any round for that person (preload.EngCompLevel), continue with AC200. Otherwise, go to END_LP20. AC200 (AC1175) BLAISE NAME: LangPref Context Header: {NAME OF MEDICAL CARE PROVIDER.......} {NAME OF FACILITY} Question Text: Does {someone at} {PROVIDER} speak the language {{PERSON 1},} {{PERSON 2},} {{PERSON 3},} {{PERSON 4},} {{and} PERSON N} {or their parents} prefer(s) or provide translator services for them? Responses: YES 1 END_LP20 (AC1180) NO 2 END_LP20 (AC1180) REFUSED RF END_LP20 (AC1180) DON'T KNOW DK END_LP20 (AC1180) Display Instructions: Display 'someone at' if USC provider being looped on is a 'FACILITY-TYPE-PROVIDER.' Otherwise, use a null display. Roster definition: Roster 1 - Report This item displays RU-members-roster for display. Display RU member’s first, middle, and last names (Person.FullName ). Display "you" rather than the respondent’s name, when respondent’s name is included in the list. Display reference person’s name, when the respondent is a proxy. Separate each name with a comma and before the last RU member’s name display an "and". Roster filter: Display all persons on the RU-members-roster who: - Identified provider being asked about as person's USC provider for the current round and -Coded RE1170_09 as ‘3’ (NOT WELL) or ‘4’ (NOT AT ALL) in any round. Display "or their parents" if all the RU members displayed in the roster are <=17 years old (or age category 1-3), otherwise, use a null display. END_LP20 (AC1180) Route Details: Cycle on next provider in the RU-medical-providers-roster who meets the conditions stated in the loop definition. If no other providers meet the stated conditions, end LOOP_20 and continue with AC210. AC210 (AC1185) BLAISE NAME: DelayCare Question Text: The following questions are about the use of health care. Do not include dental care or prescription medicines. Please think about the last 12 months, that is, between {MONTH YEAR-1} and today. {{Have you/Has {PERSON}} delayed seeking medical care/Has medical care been delayed for anyone in the household} because of worry about the cost? Responses: YES 1 AC220 (AC1186) NO 2 AC230 (AC1187) REFUSED RF AC230 (AC1187) DON'T KNOW DK AC230 (AC1187) Programmer Instructions: If coded ‘1’ (YES) and a MULTI-PERSON RU, continue with AC220. If coded ‘1’ (YES) and a SINGLE-PERSON RU, automatically code person at AC220, and go to AC230. Display Instructions: For ‘MONTH YEAR-1’ display the month of the current interview and the current interview year minus 1. Display ‘{Have you/Has {PERSON}} delayed seeking medical care’ if SINGLE-PERSON RU. Otherwise, display ‘Has medical care been delayed for anyone in the household’. AC220 (AC1186) BLAISE NAME: DelayWho Question Text: Who was that? PROBE: Did anyone else delay seeking medical care because of worry about the cost? ENTER ALL THAT APPLY. Responses: {FIRST NAME [MIDDLE NAME] LAST NAME}1 1 {FIRST NAME [MIDDLE NAME] LAST NAME}2 2 {FIRST NAME [MIDDLE NAME] LAST NAME}3 3 {FIRST NAME [MIDDLE NAME] LAST NAME}4 4 {FIRST NAME [MIDDLE NAME] LAST NAME}N 5 Programmer Instructions: Go to AC230. Display Instructions: Roster 2 - no add/edit/delete Roster definition: This item displays RU members roster for selection. Display RU member’s first, middle, and last name (Person.FullName). Roster filter: No filter; display all. AC230 (AC1187) BLAISE NAME: AffrdCare Question Text: In the last 12 months, was there any time when {{you/{PERSON}}/anyone in the household} needed medical care, but did not get it because {{you/he/she}/they} couldn’t afford it? Responses: YES 1 AC240 (AC1188) NO 2 AC250 (AC1189) REFUSED RF AC250 (AC1189) DON'T KNOW DK AC250 (AC1189) Programmer Instructions: If coded ‘1’ (YES) and a MULTI-PERSON RU, continue with AC240. If coded ‘1’ (YES) and a SINGLE-PERSON RU, automatically code person at AC240, and go to AC250. Display Instructions: Display ‘{you/{PERSON}}’ if SINGLE-PERSON RU. Otherwise, display ‘anyone in the household’. AC240 (AC1188) BLAISE NAME: AffrdWho Question Text: Who was that? PROBE: Did anyone else need medical care but did not get it because they couldn’t afford it? ENTER ALL THAT APPLY. Responses: {FIRST NAME [MIDDLE NAME] LAST NAME}1 1 {FIRST NAME [MIDDLE NAME] LAST NAME}2 2 {FIRST NAME [MIDDLE NAME] LAST NAME}3 3 {FIRST NAME [MIDDLE NAME] LAST NAME}4 4 {FIRST NAME [MIDDLE NAME] LAST NAME}N 5 Programmer Instructions: Go to AC250. Display Instructions: Roster 2 - no add/edit/delete Roster definition: This item displays RU members roster for selection. Display RU member’s first, middle, and last name (Person.FullName). Roster filter: No filter; display all. AC250 (AC1189) BLAISE NAME: DelayCareDN Question Text: Now please think only about dental care. In the last 12 months [that is, between {MONTH YEAR-1} and today], {have you/has {PERSON}} delayed seeking dental care (including check-ups)/has dental care (including check-ups) been delayed for anyone in the household} because of worry about the cost? Responses: YES 1 NO 2 AC270 (AC1191) REFUSED RF AC270 (AC1191) DON'T KNOW DK AC270 (AC1191) Programmer Instructions: If coded ‘1’ (YES) and a MULTI-PERSON RU, continue with AC260. If coded ‘1’ (YES) and a SINGLE-PERSON RU, automatically code person at AC260, and go to AC270. Display Instructions: For ‘MONTH YEAR-1’ display the month of the current interview and the current interview year minus 1. Display ‘{have you/Has {PERSON}} delayed seeking dental care (including check-ups)’ if SINGLE-PERSON RU. Otherwise, display ‘has dental care been delayed (including check-ups) for anyone in the household’. AC260 (AC1190) BLAISE NAME: DelayWhoDN Question Text: Who was that? PROBE: Did anyone else delay seeking dental care (including check-ups) because of worry about the cost? ENTER ALL THAT APPLY. Responses: {FIRST NAME [MIDDLE NAME] LAST NAME}1 1 {FIRST NAME [MIDDLE NAME] LAST NAME}2 2 {FIRST NAME [MIDDLE NAME] LAST NAME}3 3 {FIRST NAME [MIDDLE NAME] LAST NAME}4 4 {FIRST NAME [MIDDLE NAME] LAST NAME}N 5 Programmer Instructions: Go to AC270. Display Instructions: Roster 2 - no add/edit/delete Roster definition: This item displays RU members roster for selection. Display RU member’s first, middle, and last name (Person.FullName). Roster filter: No filter; display all. AC270 (AC1191) BLAISE NAME: AffrdCareDN Question Text: In the last 12 months, was there any time when {{you/{PERSON}}/anyone in the household} needed dental care, but did not get it because {{you/he/she}/they} couldn’t afford it? Responses: YES 1 NO 2 AC290 (AC1193) REFUSED RF AC290 (AC1193) DON'T KNOW DK AC290 (AC1193) Programmer Instructions: If coded ‘1’ (YES) and a MULTI-PERSON RU, continue with AC280. If coded ‘1’ (YES) and a SINGLE-PERSON RU, automatically code person at AC280, and go to AC290. Display Instructions: Display ‘{you/{PERSON}}’ if SINGLE-PERSON RU. Otherwise, display ‘anyone in the household’. AC280 (AC1192) BLAISE NAME: AffrdWhoDN Question Text: Who was that? PROBE: Did anyone else need dental care but did not get it because they couldn’t afford it? ENTER ALL THAT APPLY. Responses: {FIRST NAME [MIDDLE NAME] LAST NAME}1 1 {FIRST NAME [MIDDLE NAME] LAST NAME}2 2 {FIRST NAME [MIDDLE NAME] LAST NAME}3 3 {FIRST NAME [MIDDLE NAME] LAST NAME}4 4 {FIRST NAME [MIDDLE NAME] LAST NAME}N 5 Programmer Instructions: Go to AC290. Display Instructions: Roster 2 - no add/edit/delete Roster definition: This item displays RU members roster for selection. Display RU member’s first, middle, and last name (Person.FullName). Roster filter: No filter; display all. AC290 (AC1193) BLAISE NAME: DelayCarePM Question Text: Please think about the last 12 months, that is, between {MONTH YEAR-1} and today. {{Have you/Has {PERSON}} delayed getting prescription medicines/Have prescription medicines been delayed for anyone in the household} because of worry about the cost? Responses: YES 1 NO 2 AC310 (AC1195) REFUSED RF AC310 (AC1195) DON'T KNOW DK AC310 (AC1195) Programmer Instructions: If coded ‘1’ (YES) and a MULTI-PERSON RU, continue with AC300. If coded ‘1’ (YES) and a SINGLE-PERSON RU, automatically code person at AC300, and go to AC310. Display Instructions: For ‘MONTH YEAR-1’ display the month of the current interview and the current interview year minus 1. Display “Have you/Has {PERSON}} delayed getting prescription medicines” if SINGLE-PERSON RU. Otherwise, display ‘Have prescription medicines been delayed for anyone in the household”. AC300 (AC1194) BLAISE NAME: DelayWhoPM Question Text: Who was that? PROBE: Did anyone else delay getting prescription medicines because of worry about the cost? ENTER ALL THAT APPLY. Responses: {FIRST NAME [MIDDLE NAME] LAST NAME}1 1 {FIRST NAME [MIDDLE NAME] LAST NAME}2 2 {FIRST NAME [MIDDLE NAME] LAST NAME}3 3 {FIRST NAME [MIDDLE NAME] LAST NAME}4 4 {FIRST NAME [MIDDLE NAME] LAST NAME}N 5 Programmer Instructions: Go to AC310. Display Instructions: Roster 2 - no add/edit/delete Roster definition: This item displays RU members roster for selection. Display RU member’s first, middle, and last name (Person.FullName). Roster filter: No filter; display all. AC310 (AC1195) BLAISE NAME: AffrdCarePM Question Text: In the last 12 months, was there any time when {{you/{PERSON}}/anyone in the household} needed prescription medicines, but did not get it because {{you/he/she}/they} couldn’t afford it? Responses: YES 1 NO 2 BOX_110 (AC1215) REFUSED RF BOX_110 (AC1215) DON'T KNOW DK BOX_110 (AC1215) Programmer Instructions: If coded ‘1’ (YES) and a MULTI-PERSON RU, continue with AC320. If coded ‘1’ (YES) and a SINGLE-PERSON RU, automatically code person at AC320 and go to BOX_110. Display Instructions: Display ‘{you/{PERSON}}’ if SINGLE-PERSON RU. Otherwise, display ‘anyone in the household’. AC320 (AC1196) BLAISE NAME: AffrdWhoPM Question Text: Who was that? PROBE: Did anyone else need prescription medicines but did not get it because they couldn’t afford it? ENTER ALL THAT APPLY. Responses: {FIRST NAME [MIDDLE NAME] LAST NAME}1 1 {FIRST NAME [MIDDLE NAME] LAST NAME}2 2 {FIRST NAME [MIDDLE NAME] LAST NAME}3 3 {FIRST NAME [MIDDLE NAME] LAST NAME}4 4 {FIRST NAME [MIDDLE NAME] LAST NAME}N 5 Programmer Instructions: Go to BOX_110. Display Instructions: Roster 2 - no add/edit/delete Roster definition: This item displays RU members roster for selection. Display RU member’s first, middle, and last name (Person.FullName). Roster filter: No filter; display all. BOX_110 (AC1215) Route Details: Go to next questionnaire section. |