==========================================================================================
Section N: HEALTH SERVICES AND INSURANCE (Respondent)
==========================================================================================
HHID HOUSEHOLD IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 6 Decimals: 0
.................................................................................
1310 010465-502582. Household Identification Number
==========================================================================================
PN RESPONDENT PERSON IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
.................................................................................
853 010. Person Identifier
15 011. Person Identifier
1 012. Person Identifier
332 020. Person Identifier
1 021. Person Identifier
52 030. Person Identifier
3 031. Person Identifier
52 040. Person Identifier
1 041. Person Identifier
==========================================================================================
USUBHH 2006 SUB HOUSEHOLD IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 1 Decimals: 0
.................................................................................
1275 3. 1st deceased respondent from a household
35 4. 2nd deceased respondent from a household
==========================================================================================
JSUBHH 2004 SUB HOUSEHOLD IDENTIFICATION NUMBER
Section: N Level: Respondent Type: Character Width: 1 Decimals: 0
.................................................................................
1258 0. Original sample household - no split from divorce or
separation of spouses or partners
29 1. Split household - one half of couple from SUBHH 0 and new
spouse or partner, if any
13 2. Split household - one half of couple from SUBHH 0 and new
spouse or partner, if any
4 3. 1st deceased respondent from a household
3 5. Split household - one half of couple from SUBHH 1 or 2
6. Split household - one half of couple from SUBHH 1 or 2
3 7. Reunited household - respondents from split household
reunite
==========================================================================================
UPN_SP 2006 SPOUSE/PARTNER PERSON NUMBER
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
.................................................................................
218 010. Person Identifier
20 011. Person Identifier
1 012. Person Identifier
277 020. Person Identifier
4 021. Person Identifier
28 030. Person Identifier
1 031. Person Identifier
1 032. Person Identifier
34 040. Person Identifier
3 041. Person Identifier
1 811. New Spouse of Non-Original Respondent
1 841. New Spouse of Non-Original Respondent
721 Blank. R not coupled
==========================================================================================
UN001 MEDICARE COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.GovCover.N001_
The next questions are about health insurance, both public and private. Medicare
is a public health insurance program for people 65 or older and for disabled
persons. (Medicaid/State name for Medicaid) is a public health insurance program
for people with low incomes.
Was [FIRST NAME] covered by Medicare health insurance at the time of [her/his]
death?
.................................................................................
1152 1. YES
131 5. NO
22 8. DK (Don't Know); NA (Not Ascertained)
2 9. RF (Refused)
3 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN002M1 WHY NOT MEDICARE COVERED-1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.GovCover.N002_
Why was that?
IF R WAS MORE THAN 65 WHEN S/HE DIED (A019 ge 65):
[IWER: R WAS AGE R’s AGE (per A019), SO PROBE WHY R WAS NOT COVERED BY
MEDICARE]
IF R WAS 65 OR LESS WHEN S/HE DIED (A019 < 65):
[IWER: R WAS AGE R’s AGE (per A019), SO PROBE WHY R WAS COVERED BY MEDICARE]
.................................................................................
28 1. R is disabled; R is on disability; Spouse on disability; R
is on Social Security disability or SSI
4 2. R has a specific medical problem. (E.g. If R says; 'Disabled
due to medical condition,' code it as 02, not 01)
1 3. R has Medicare-NFS
4. R mentions has Part A and Part B of Medicare
5. R mentions has Part A of Medicare; the first half of
Medicare
6. R mentions has Part B of Medicare; the second half of
Medicare
7. R mentions a Medicare card or the mechanics of using it
8. R receives Medicare through a deceased spouse
9. R mentions his/her age in conjunction with having Medicare;
R has had Medicare since a certain age; R got Medicare
'early'
10. R pays into Medicare, but doesn't use it; R has Medicare,
but chooses not to use it
2 50. R never applied for Medicare or invested in it-NFS
1 51. R didn't work long enough to qualify for Medicare; R didn't
work enough quarters; R's spouse didn't work enough quarters
to qualify
52. R is still working (If R mentions other insurance coverage
through his/her employment, code the appropriate insurance
code only)
2 53. R never qualified for Medicare in his/her employment; R was
in the military/a federal employee/a postal worker etc.; R
doesn't get Social Security or Medicaid
1 54. R used to have Medicare-NFS; R had Medicare, but not now; R
dropped it
1 55. Medicare charges too much; Medicare too expensive for what
you receive
10 56. R will be on Medicare in the future; R not old enough to
qualify at present; R in the process of getting Medicare
57. R had Medicare through a deceased spouse and R no longer
receives it
58. R's spouse only receives Medicare
59. R is not familiar with Medicare; confusion about eligibility
1 70. R has other medical insurance/coverage-NFS
2 71. R has veteran's coverage or insurance; 'I'm covered by the
VA'
72. R has federal employee/Postal Service insurance
3 73. R has private insurance; e.g. Cigna, Kaiser, Blue Cross/Blue
Shield
15 74. R is covered by Medicaid
1 75. R's spouse's medical insurance covers R
4 76. R covered under company health plan or health insurance; R
covered under former employer's health plan or health
insurance
2 90. R mentions income level/group, home ownership, an economic
factor
91. R mentions Social Security; e.g. 'I have Social Security,'
(Note that all mentions of SSI or disability go under codes
01 or 02)
3 92. R is not a U.S. citizen; R is an illegal alien; R lives
outside the USA
93. R doesn’t need it - NFS
94. R "used it up"
95. R disputes age calculation
97. Other
15 98. DK (Don't know); NA (Not ascertained)
2 99. RF (Refused)
1212 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN002M2 WHY NOT MEDICARE COVERED-2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.GovCover.N002_
Why was that?
IF R WAS MORE THAN 65 WHEN S/HE DIED (A019 ge 65):
[IWER: R WAS AGE R’s AGE (per A019), SO PROBE WHY R WAS NOT COVERED BY
MEDICARE]
IF R WAS 65 OR LESS WHEN S/HE DIED (A019 < 65):
[IWER: R WAS AGE R’s AGE (per A019), SO PROBE WHY R WAS COVERED BY MEDICARE]
.................................................................................
1. R is disabled; R is on disability; Spouse on disability; R
is on Social Security disability or SSI
2. R has a specific medical problem. (E.g. If R says; 'Disabled
due to medical condition,' code it as 02, not 01)
3. R has Medicare-NFS
4. R mentions has Part A and Part B of Medicare
5. R mentions has Part A of Medicare; the first half of
Medicare
6. R mentions has Part B of Medicare; the second half of
Medicare
7. R mentions a Medicare card or the mechanics of using it
8. R receives Medicare through a deceased spouse
9. R mentions his/her age in conjunction with having Medicare;
R has had Medicare since a certain age; R got Medicare
'early'
10. R pays into Medicare, but doesn't use it; R has Medicare,
but chooses not to use it
50. R never applied for Medicare or invested in it-NFS
51. R didn't work long enough to qualify for Medicare; R didn't
work enough quarters; R's spouse didn't work enough quarters
to qualify
52. R is still working (If R mentions other insurance coverage
through his/her employment, code the appropriate insurance
code only)
1 53. R never qualified for Medicare in his/her employment; R was
in the military/a federal employee/a postal worker etc.; R
doesn't get Social Security or Medicaid
1 54. R used to have Medicare-NFS; R had Medicare, but not now; R
dropped it
55. Medicare charges too much; Medicare too expensive for what
you receive
56. R will be on Medicare in the future; R not old enough to
qualify at present; R in the process of getting Medicare
57. R had Medicare through a deceased spouse and R no longer
receives it
58. R's spouse only receives Medicare
59. R is not familiar with Medicare; confusion about eligibility
70. R has other medical insurance/coverage-NFS
71. R has veteran's coverage or insurance; 'I'm covered by the
VA'
1 72. R has federal employee/Postal Service insurance
73. R has private insurance; e.g. Cigna, Kaiser, Blue Cross/Blue
Shield
74. R is covered by Medicaid
75. R's spouse's medical insurance covers R
76. R covered under company health plan or health insurance; R
covered under former employer's health plan or health
insurance
1 90. R mentions income level/group, home ownership, an economic
factor
91. R mentions Social Security; e.g. 'I have Social Security,'
(Note that all mentions of SSI or disability go under codes
01 or 02)
92. R is not a U.S. citizen; R is an illegal alien; R lives
outside the USA
93. R doesn’t need it - NFS
94. R "used it up"
7 95. R disputes age calculation
97. Other
98. DK (Don't know); NA (Not ascertained)
99. RF (Refused)
1299 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N001_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN004 MEDICARE PART B COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.GovCover.N004_
Part A of Medicare covers most hospital expenses.
Part B covers many doctors' expenses including doctor visits, and the premium is
usually deducted from [her/his] Social Security.
At the time of [FIRST NAME]'s death, was [she/he] covered by Medicare Part B?
.................................................................................
1031 1. YES
36 5. NO
85 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
158 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N001_ = YES;
IF A123_YRDEATH > 2005;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN352 SIGNED UP MEDICARE PRESCRIPTION COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.GovCover.N352_
Beginning in 2006, Part D of Medicare provides coverage for prescription drugs.
Had [FIRST NAME] signed up for the new Medicare prescription drug coverage?
.................................................................................
89 1. YES
14 3. [VOL] ENROLLED IN IT AUTOMATICALLY
173 5. NO
28 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1006 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN005 MEDICAID COVERAGE SINCE PREV WAVE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.GovCover.N005_
Was [she/he] covered by health insurance through (Medicaid/State name for
Medicaid or any other Medicaid program) at any time [between [PREV WAVE FIRST R
IW MONTH], [PREV WAVE FIRST R IW YEAR] and when [she/he] died/in the two years
before [her/his] death] ?
.................................................................................
334 1. YES
917 5. NO
55 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N005_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN006 CURRENTLY COVERED BY MEDICAID
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.GovCover.N006_
Was [she/he] covered by (Medicaid/State name for Medicaid) at the time [she/he]
died?
.................................................................................
323 1. YES
10 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
976 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN007 CHAMPUS/CHAMPVA COVERAGE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.GovCover.N007_
At the time of [her/his] death, was [she/he] covered by TRI-CARE, CHAMPUS,
CHAMP-VA, or any other military health care plan?
Def: (TRI-CARE is the new name for the military's health insurance programs.
It includes what used to be known as CHAMPUS and CHAMP-VA. CHAMPUS was a health
care program for active or retired military personnel and their dependents or
survivors. CHAMP-VA provided medical care for veterans and their dependents or
survivors of veterans who had a service-connected disability. VA is not a health
insurance program.)
.................................................................................
74 1. YES
1210 5. NO
22 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN009 MEDICARE/MEDICAID HMO
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.MediCaidCarePlan.N009_
We are interested in how [her/his] (Medicare/Medicare or (Medicaid/State name
for Medicaid)) health insurance worked for routine care.
Did [FIRST NAME] receive [her/his] [Medicare /(Medicaid/State name for
MEDICAID)] benefits through an HMO, that is a Health Maintenance Organization?
Def: (With an HMO, the cost of the physician visit is typically covered in
full or you pay only a small amount. All of your routine care must be provided
by an HMO physician.)
.................................................................................
200 1. YES
835 5. NO
159 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
116 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF (piGovCoverN001_ = YES) AND (N009_ = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN243 HMO NEEDED FOR OTHER BENS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.MediCaidCarePlan.N243_
Did [she/he] have to join this HMO in order to receive supplemental benefits
from another plan?
.................................................................................
46 1. YES
120 5. NO
30 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1114 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF N009_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN010 MEDICARE/MEDICAID HMO- HOW LONG - YRS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.MediCaidCarePlan.N010_
At the time of [her/his] death, about how long had [she/he] been receiving
[her/his] [Medicare /(Medicaid/State name for MEDICAID)] benefits through this
HMO?
Years:
Or
Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
139 1 25 9.33 6.90 1121
-----------------------------------------------------------------
50 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF N009_ = YES;
IF (N010_ = 0) OR N010_ = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN011 MEDICARE/MEDICAID HMO- HOW LONG - MOS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.MediCaidCarePlan.N011_
At the time of [her/his] death, about how long had [she/he] been receiving
[her/his] [Medicare /(Medicaid/State name for MEDICAID)] benefits through this
HMO?
Years: [MEDICARE/MEDICAID HMO- HOW LONG - YRS]
Or
Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
12 2 30 9.17 7.61 1249
-----------------------------------------------------------------
49 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF N009_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN351 HMO PAY FOR REGULAR PRESCRIPTION DRUGS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.MediCaidCarePlan.N351_
Did this HMO cover or provide help with paying for regular prescription drugs?
.................................................................................
149 1. YES
43 5. NO
8 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1110 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF N009_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN014 MEDICARE/MEDICAID HMO-AMT PAY
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.MediCaidCarePlan.N014_
Not including co-pays or deductions from [her/his] Social Security, how much did
[she/he], [herself/himself], pay in premiums for this plan?
IWER: DO NOT PROBE DK/RF
Amount:
Per:
.................................................................................
136 0-749. Actual Value
63 998. DK (Don't Know); NA (Not Ascertained)
1 999. RF (Refused)
1110 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF N009_ = YES;
IF ((N014_ > 0) AND (N014_ <> REFUSAL)) AND (N014_ <> DONTKNOW);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN018 MEDICARE/MEDICAID HMO-AMT PAY - PER
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.MediCaidCarePlan.N018_
Not including co-pays or deductions from [her/his] Social Security, how much did
[she/he], [herself/himself], pay for this plan?
Amount: [MEDICARE/MEDICAID HMO-AMT PAY]
Per:
.................................................................................
66 1. MONTH
4 2. QUARTER (EVERY 3 MONTHS)
3. SEMI-ANNUALLY (EVERY 6 MONTHS/TWICE A YEAR)
1 4. YEAR
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1239 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N015_ := EMPTY:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF N009_ = YES;
IF N014_ <> EMPTY AND N014_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN015 MEDICARE/MEDICAID HMO-AMT PAY - MIN
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.MediCaidCarePlan.N015_
N015-N017 Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or what?
PROCEDURES: 2Up1Down, 1Up2Down
BREAKPOINTS: $30, $60, $100, $200
RANDOM ENTRY POINTS: $60, $100
ENTRY POINT ASSIGNMENT: 1 or {NOT 1} AT X501
.................................................................................
41 0. Value of Breakpoint
3 30. Value of Breakpoint
4 31. Value of Breakpoint
4 60. Value of Breakpoint
5 61. Value of Breakpoint
2 100. Value of Breakpoint
5 201. Value of Breakpoint
1246 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N016_ := EMPTY:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF N009_ = YES;
IF N014_ <> EMPTY AND N014_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN016 MEDICARE/MEDICAID HMO-AMT PAY - MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.MediCaidCarePlan.N016_
.................................................................................
2 29. Value of Breakpoint
3 30. Value of Breakpoint
5 59. Value of Breakpoint
4 60. Value of Breakpoint
5 99. Value of Breakpoint
2 100. Value of Breakpoint
43 99999996. Greater than Maximum Breakpoint
1246 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N017_ := EMPTY:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF N009_ = YES;
IF N014_ <> EMPTY AND N014_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN017 MEDICARE/MEDICAID HMO-AMT PAY - RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.MediCaidCarePlan.N017_
.................................................................................
39 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
1270 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF piGovCoverN001_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN020 LEFT MEDICARE HMO LAST TWO YRS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.MediCaidCarePlan.N020_
At any time [[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW
YEAR]/in the last two years before her/his death]], did [she/he] leave an HMO
that delivered Medicare services?
.................................................................................
14 1. YES
1036 5. NO
102 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
158 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF piGovCoverN001_ = YES;
IF N020_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN021M1 WHY LEAVE MEDICARE HMO-1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.MediCaidCarePlan.N021M[1]
Why did [she/he] leave that HMO?
IWER: CHOOSE ALL THAT APPLY
.................................................................................
1. OWN PHYSICIAN LEFT PLAN
4 2. HMO DIDN'T PROVIDE NEEDED SERVICES
3 3. HMO COSTS INCREASED; found cheaper plan
4. HMO ENCOURAGED ME TO LEAVE
2 5. PLAN NO LONGER AVAILABLE
1 6. Too far away from HMO; R moved; HMO not in region
10. Switched to Medicare
1 11. R retired, left, or changed jobs
13. Lost coverage; NFS
2 14. Better coverage with new plan
1 97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1296 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piGovCoverN001_ = YES) OR (piGovCoverN006_ = YES);
IF piGovCoverN001_ = YES;
IF N020_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN021M2 WHY LEAVE MEDICARE HMO-2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.MediCaidCarePlan.N021M[2]
Why did [she/he] leave that HMO?
IWER: CHOOSE ALL THAT APPLY
.................................................................................
1. OWN PHYSICIAN LEFT PLAN
2. HMO DIDN'T PROVIDE NEEDED SERVICES
3. HMO COSTS INCREASED; found cheaper plan
4. HMO ENCOURAGED ME TO LEAVE
5. PLAN NO LONGER AVAILABLE
6. Too far away from HMO; R moved; HMO not in region
10. Switched to Medicare
11. R retired, left, or changed jobs
13. Lost coverage; NFS
14. Better coverage with new plan
97. OTHER (SPECIFY)
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1310 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN023 NUM PRIVATE HEALTH INS PLANS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.N023_
Now, we'd like to ask about the other types of health insurance plans [she/he]
might have had, such as insurance through an employer or a business, coverage
for retirees, or health insurance [she/he] might have bought for
[herself/himself], including any [Medigap or] other supplemental coverage.
Do NOT include long-term care insurance[. Other than [her/his] Medicare HMO
you`ve just told me about, how/, or anything that you have just told me about.
How] many other such plans did [she/he] have at the time of [her/his] death?
IWER: ENTER ZERO FOR NONE
Number of plans:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1260 0 3 0.54 0.54 3
-----------------------------------------------------------------
45 98. DK (Don't Know); NA (Not Ascertained)
2 99. RF (Refused)
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF piGovCoverN001_ = YES;
IF Counter = 1;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN025_1 WHICH IS PRIMARY PLAN-PRIVATE/MEDICARE-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N025_
Which was [her/his] primary plan, Medicare or [NAME PRIVATE HEALTH INSURANCE
PLAN] ?
.................................................................................
512 1. MEDICARE
60 2. [NAME PRIVATE HEALTH INSURANCE PLAN]
6 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
731 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN032_1 PRIVATE PLAN 1-3 HELP PAY REGULAR RX- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N032_
Did [NAME PRIVATE HEALTH INSURANCE PLAN] provide help with paying for regular
prescription drugs?
IWER: THE FOLLOW-UP QUESTIONS REFER TO THE PRIVATE PLAN, NOT TO MEDICARE.
.................................................................................
377 1. YES
238 5. NO
36 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
659 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN033_1 OBTAIN HI THRU CURRNT EMP/OWN BUSINESS-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N033_HowObtIns
Did [she/he] obtain this health insurance through [her/his] own business or an
employer?
IWER: ASK `WHOSE EMPLOYER?` IF NOT CLEAR
.................................................................................
32 1. YES
30 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1247 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN034_1 OBTAIN INS THRU FORMER EMPLOYER -1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N034_
Did [she/he] obtain this health insurance through a former employer of
[hers/his]?
.................................................................................
203 1. YES
401 5. NO
15 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
691 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF ((((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss
= PARTNERED_VOL)) OR (SecB.B063_MarStatAssign = ANULLED)) OR
(SecB.B063_MarStatAssign = SEPARATED)) OR (SecB.B063_MarStatAssign = DIVORCED);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN035_1 OBTAIN INS THRU HWP CURRENT EMPLOYER- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N035_
Did [she/he] obtain this health insurance through [your/[her/his] [former]
[husband/wife/partner]`s] current employer?
.................................................................................
26 1. YES
180 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1102 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF ((N035_ <> YES) AND N035_ <> EMPTY) OR (SecB.B063_MarStatAssign = WIDOWED);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN036_1 OBTAIN INS THRU HWP FORMER EMPLOYER- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N036_
Did [she/he] obtain this health insurance through [her/his] [former]
[spouse/partner]'s former employer?
.................................................................................
100 1. YES
265 5. NO
15 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
930 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF (N035_ <> YES) AND (N036_ <> YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN037_1 WHERE PURCHASE PRIVATE PLAN INSURANCE- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N037_
Did [she/he] purchase this plan directly from an insurance company, through
[her/his] [or [her/his] [husband's/wife's/partner`s]/or your] union,
through a group such as AARP, a church, or other organization, or what?
.................................................................................
202 1. INSURANCE COMPANY
2. R`S UNION
3. SPOUSE`S UNION
56 4. GROUP
2 5. Former or deceased spouse's employer/union
7 6. Includes federal, state or military programs
4 7. OTHER (SPECIFY)
19 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1020 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN039_1 PAY ALL/SOME/NONE PRIV PLAN HI COSTS-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N039_PayHlthInsCost
Including any help from [her/his] family, did [she/he] [or/ or her/his]
[you/husband/wife/partner] pay all of the costs, some of the costs, or none of
the costs of the premium for this health insurance coverage?
.................................................................................
405 1. ALL
125 2. SOME
103 3. NONE
16 8. DK (Don't Know); NA (Not Ascertained)
2 9. RF (Refused)
659 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN040_1 PRIV PLAN HI PAY PER/MONTH- AMT- 1
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.PlanDetails[1].N040_
How much did [she/he] [or/ or her/his] [you/husband/wife/partner] pay per month
in premiums for this plan?
[IWER: PROBE IF NECESSARY. Count any payroll deductions, but do not include any
amount paid by the employer]
IWER: DO NOT PROBE DK/RF
Amount per Month:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
352 0 1400 188.78 137.18 762
-----------------------------------------------------------------
193 9998. DK (Don't Know); NA (Not Ascertained)
3 9999. RF (Refused)
==========================================================================================
*Assign N041_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN041_1 PRIV PLAN HI PAY PER/MONTH- MIN- 1
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.PlanDetails[1].N041_
N041-N043 Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $50, $100, $150, $300, $500
RANDOM ENTRY POINTS: $100, $150, $300
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X515
.................................................................................
79 0. Value of Breakpoint
4 50. Value of Breakpoint
12 51. Value of Breakpoint
8 100. Value of Breakpoint
16 101. Value of Breakpoint
15 150. Value of Breakpoint
49 151. Value of Breakpoint
6 300. Value of Breakpoint
3 301. Value of Breakpoint
3 501. Value of Breakpoint
1115 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N042_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN042_1 PRIV PLAN HI PAY PER/MONTH- MAX- 1
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.PlanDetails[1].N042_
.................................................................................
4 49. Value of Breakpoint
4 50. Value of Breakpoint
14 99. Value of Breakpoint
8 100. Value of Breakpoint
22 149. Value of Breakpoint
15 150. Value of Breakpoint
19 299. Value of Breakpoint
6 300. Value of Breakpoint
3 499. Value of Breakpoint
100 99999996. Greater than Maximum Breakpoint
1115 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N043_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN043_1 PRIV PLAN HI PAY PER/MONTH- RESULT- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[1].N043_
.................................................................................
1 97. Data not available
109 98. DK (Don't Know); NA (Not Ascertained)
2 99. RF (Refused)
1198 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N044_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF piSecJWorkstatusJ021_EmpSelfOth = SLFEMPD);
*Assign N044_ := RISCURRLYSLFEMPD:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF piSecJWorkstatusJ021_EmpSelfOth = SLFEMPD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN044_1 BRANCHPNT-SELF EMPLOYED/ALL OTH-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N044_
.................................................................................
1. R IS CURRENTLY SELF-EMPLOYED
548 2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
762 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N046_ := INSTHRUCURFOREMPORUNION:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)));
*NOT(ELSE)*(IF N037_ = OTH_SPECIFY);
*Assign N046_ := INSTHRUSOMEPLACEELSEATR15:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)));
IF N037_ = OTH_SPECIFY;
*Assign N046_ := INSTHRUSPANDRISMDS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF ((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss =
PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ = YES));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN046_1 BRANCHPNT-SOURCE OF HEALTH INSURANCE- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N046_
.................................................................................
56 1. INS THRU SPOUSE AND R IS MARRIED, DIVORCED, OR SEPARATED
11 2. INS THRU SOMEPLACE ELSE
481 3. INS THRU CURRENT/FORMER EMPLOYER
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
762 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N047_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF piGovCoverN001_ = YES);
*Assign N047_ := RISCOVEREDBYMCARE:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF piGovCoverN001_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN047_1 BRANCHPNT-COVERD BY MEDICARE/ALL OTH- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N047_
.................................................................................
492 1. R IS COVERED BY MEDICARE
56 2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
762 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN052_1 PRIVATE PLAN INSURANCE AN HMO- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N052_Plan1HMO
Was this plan an hmo, that is, a health maintenance organization?
Def: (With an HMO, the cost of the physician visit is typically covered in
full or you pay only a small amount. All of your routine care must be provided
by an HMO physician.)
.................................................................................
75 1. YES
525 5. NO
50 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
659 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN053_1 NUMBER YEARS IN PLAN- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[1].N053_NumYrPlan
How long had [she/he] been with this plan?
Years:
Or
Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
519 0 50 18.98 13.61 673
-----------------------------------------------------------------
117 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (N053_NumYrPlan = 0) OR N053_NumYrPlan = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN054_1 NUMBER MONTHS IN PLAN- 1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[1].N054_NumMoPlan
How long has [she/he] been with this plan?
Years:
Or
Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
16 1 12 4.94 3.66 1178
-----------------------------------------------------------------
115 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N052_Plan1HMO <> YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN055_1 PRIV PLAN HI- HAS LIST OF DRS- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N055_ListDoctor
Did this health insurance plan have a list or book of doctors that [she/he] was
encouraged or required to use?
.................................................................................
97 1. YES
427 5. NO
52 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
734 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (N055_ListDoctor = YES) OR (N052_Plan1HMO = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN056_1 PLAN PAY FOR DOCTORS NOT ON LIST- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N056_DocNotList
Did [this health insurance plan/the HMO] pay any of the costs for routine care
if [she/he] saw a doctor who was not [on this list/in the HMO]?
.................................................................................
91 1. YES
22 2. YES, WITH A REFERRAL
34 5. NO
25 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1138 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N058_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns =
YES));
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N034_ = YES));
*Assign N058_ := HLTHINSFORMEREMPLESS65:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns =
YES));
IF (piSecAContinuInterviewA019_RAge < 65) AND (N034_ = YES);
*Assign N058_ := HLTHINSFROMCUREMPLESS65:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN058_1 PRIV HI FROM CUR/FOR EMP AND LESS 65-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N058_
.................................................................................
16 1. R HAS HEALTH INS FROM CURRENT EMPLOYER AND R IS LESS THAN 65
22 2. R HAS HEALTH INS FROM FORMER EMPLOYER AND R IS LESS THAN 65
613 3. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
659 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN066_1 LIMITS ON HI DUE TO PREEXISTING COND- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[1].N066_LimitHlthIns
Were there any limits or restrictions on this health insurance plan due to a
preexisting condition?
.................................................................................
11 1. YES
588 5. NO
52 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
659 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN032_2 PRIVATE PLAN 1-3 HELP PAY REGULAR RX- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N032_
Did [NAME PRIVATE HEALTH INSURANCE PLAN] provide help with paying for regular
prescription drugs?
IWER: THE FOLLOW-UP QUESTIONS REFER TO THE PRIVATE PLAN, NOT TO MEDICARE.
.................................................................................
11 1. YES
12 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1287 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN033_2 OBTAIN HI THRU CURRNT EMP/OWN BUSINESS-2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N033_HowObtIns
Did [she/he] obtain this health insurance through [her/his] own business or an
employer?
IWER: ASK `WHOSE EMPLOYER?` IF NOT CLEAR
.................................................................................
1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN034_2 OBTAIN INS THRU FORMER EMPLOYER -2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N034_
Did [she/he] obtain this health insurance through a former employer of
[hers/his]?
.................................................................................
5 1. YES
18 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1287 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF ((((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss
= PARTNERED_VOL)) OR (SecB.B063_MarStatAssign = ANULLED)) OR
(SecB.B063_MarStatAssign = SEPARATED)) OR (SecB.B063_MarStatAssign = DIVORCED);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN035_2 OBTAIN INS THRU HWP CURRENT EMPLOYER- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N035_
Did [she/he] obtain this health insurance through [your/[her/his] [former]
[husband/wife/partner]`s] current employer?
.................................................................................
2 1. YES
8 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1300 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF ((N035_ <> YES) AND N035_ <> EMPTY) OR (SecB.B063_MarStatAssign = WIDOWED);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN036_2 OBTAIN INS THRU HWP FORMER EMPLOYER- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N036_
Did [she/he] obtain this health insurance through [her/his] [former]
[spouse/partner]'s former employer?
.................................................................................
2 1. YES
14 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1294 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF (N035_ <> YES) AND (N036_ <> YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN037_2 WHERE PURCHASE PRIVATE PLAN INSURANCE- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N037_
Did [she/he] purchase this plan directly from an insurance company, through
[her/his] [or [her/his] [husband's/wife's/partner`s]/or your] union,
through a group such as AARP, a church, or other organization, or what?
.................................................................................
10 1. INSURANCE COMPANY
1 2. R`S UNION
3. SPOUSE`S UNION
2 4. GROUP
5. Former or deceased spouse's employer/union
6. Includes federal, state or military programs
1 7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1296 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN039_2 PAY ALL/SOME/NONE PRIV PLAN HI COSTS-2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N039_PayHlthInsCost
Including any help from [her/his] family, did [she/he] [or/ or her/his]
[you/husband/wife/partner] pay all of the costs, some of the costs, or none of
the costs of the premium for this health insurance coverage?
.................................................................................
13 1. ALL
2 2. SOME
7 3. NONE
8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
1287 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN040_2 PRIV PLAN HI PAY PER/MONTH- AMT- 2
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.PlanDetails[2].N040_
How much did [she/he] [or/ or her/his] [you/husband/wife/partner] pay per month
in premiums for this plan?
[IWER: PROBE IF NECESSARY. Count any payroll deductions, but do not include any
amount paid by the employer]
IWER: DO NOT PROBE DK/RF
Amount per Month:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
12 7 200 70.67 55.26 1294
-----------------------------------------------------------------
3 9998. DK (Don't Know); NA (Not Ascertained)
1 9999. RF (Refused)
==========================================================================================
*Assign N041_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN041_2 PRIV PLAN HI PAY PER/MONTH- MIN- 2
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.PlanDetails[2].N041_
N041-N043 Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $50, $100, $150, $300, $500
RANDOM ENTRY POINTS: $100, $150, $300
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X515
.................................................................................
3 0. Value of Breakpoint
1 151. Value of Breakpoint
1306 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N042_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN042_2 PRIV PLAN HI PAY PER/MONTH- MAX- 2
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.PlanDetails[2].N042_
.................................................................................
1 49. Value of Breakpoint
1 299. Value of Breakpoint
2 99999996. Greater than Maximum Breakpoint
1306 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N043_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN043_2 PRIV PLAN HI PAY PER/MONTH- RESULT- 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[2].N043_
.................................................................................
2 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
1307 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N044_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF piSecJWorkstatusJ021_EmpSelfOth = SLFEMPD);
*Assign N044_ := RISCURRLYSLFEMPD:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF piSecJWorkstatusJ021_EmpSelfOth = SLFEMPD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN044_2 BRANCHPNT-SELF EMPLOYED/ALL OTH-2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N044_
.................................................................................
1. R IS CURRENTLY SELF-EMPLOYED
16 2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1294 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N046_ := INSTHRUCURFOREMPORUNION:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)));
*NOT(ELSE)*(IF N037_ = OTH_SPECIFY);
*Assign N046_ := INSTHRUSOMEPLACEELSEATR15:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)));
IF N037_ = OTH_SPECIFY;
*Assign N046_ := INSTHRUSPANDRISMDS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF ((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss =
PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ = YES));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN046_2 BRANCHPNT-SOURCE OF HEALTH INSURANCE- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N046_
.................................................................................
2 1. INS THRU SPOUSE AND R IS MARRIED, DIVORCED, OR SEPARATED
3 2. INS THRU SOMEPLACE ELSE
11 3. INS THRU CURRENT/FORMER EMPLOYER
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1294 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N047_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF piGovCoverN001_ = YES);
*Assign N047_ := RISCOVEREDBYMCARE:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF piGovCoverN001_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN047_2 BRANCHPNT-COVERD BY MEDICARE/ALL OTH- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N047_
.................................................................................
12 1. R IS COVERED BY MEDICARE
4 2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1294 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN052_2 PRIVATE PLAN INSURANCE AN HMO- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N052_Plan1HMO
Was this plan an hmo, that is, a health maintenance organization?
Def: (With an HMO, the cost of the physician visit is typically covered in
full or you pay only a small amount. All of your routine care must be provided
by an HMO physician.)
.................................................................................
2 1. YES
19 5. NO
2 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1287 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN053_2 NUMBER YEARS IN PLAN- 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[2].N053_NumYrPlan
How long had [she/he] been with this plan?
Years:
Or
Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
18 1 30 14.78 9.61 1287
-----------------------------------------------------------------
5 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (N053_NumYrPlan = 0) OR N053_NumYrPlan = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN054_2 NUMBER MONTHS IN PLAN- 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[2].N054_NumMoPlan
How long has [she/he] been with this plan?
Years:
Or
Months:
.................................................................................
5 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1305 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N052_Plan1HMO <> YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN055_2 PRIV PLAN HI- HAS LIST OF DRS- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N055_ListDoctor
Did this health insurance plan have a list or book of doctors that [she/he] was
encouraged or required to use?
.................................................................................
1 1. YES
16 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1289 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (N055_ListDoctor = YES) OR (N052_Plan1HMO = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN056_2 PLAN PAY FOR DOCTORS NOT ON LIST- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N056_DocNotList
Did [this health insurance plan/the HMO] pay any of the costs for routine care
if [she/he] saw a doctor who was not [on this list/in the HMO]?
.................................................................................
1. YES
1 2. YES, WITH A REFERRAL
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1307 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N058_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns =
YES));
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N034_ = YES));
*Assign N058_ := HLTHINSFORMEREMPLESS65:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns =
YES));
IF (piSecAContinuInterviewA019_RAge < 65) AND (N034_ = YES);
*Assign N058_ := HLTHINSFROMCUREMPLESS65:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN058_2 PRIV HI FROM CUR/FOR EMP AND LESS 65- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N058_
.................................................................................
1. R HAS HEALTH INS FROM CURRENT EMPLOYER AND R IS LESS THAN 65
1 2. R HAS HEALTH INS FROM FORMER EMPLOYER AND R IS LESS THAN 65
22 3. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1287 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN066_2 LIMITS ON HI DUE TO PREEXISTING COND- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[2].N066_LimitHlthIns
Were there any limits or restrictions on this health insurance plan due to a
preexisting condition?
.................................................................................
1. YES
19 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1287 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN032_3 PRIVATE PLAN 1-3 HELP PAY REGULAR RX- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N032_
Did [NAME PRIVATE HEALTH INSURANCE PLAN] provide help with paying for regular
prescription drugs?
IWER: THE FOLLOW-UP QUESTIONS REFER TO THE PRIVATE PLAN, NOT TO MEDICARE.
.................................................................................
1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN033_3 OBTAIN HI THRU CURRNT EMP/OWN BUSINESS-3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N033_HowObtIns
Did [she/he] obtain this health insurance through [her/his] own business or an
employer?
IWER: ASK `WHOSE EMPLOYER?` IF NOT CLEAR
.................................................................................
1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1310 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN034_3 OBTAIN INS THRU FORMER EMPLOYER -3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N034_
Did [she/he] obtain this health insurance through a former employer of
[hers/his]?
.................................................................................
1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF ((((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss
= PARTNERED_VOL)) OR (SecB.B063_MarStatAssign = ANULLED)) OR
(SecB.B063_MarStatAssign = SEPARATED)) OR (SecB.B063_MarStatAssign = DIVORCED);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN035_3 OBTAIN INS THRU HWP CURRENT EMPLOYER- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N035_
Did [she/he] obtain this health insurance through [your/[her/his] [former]
[husband/wife/partner]`s] current employer?
.................................................................................
1. YES
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1310 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF ((N035_ <> YES) AND N035_ <> EMPTY) OR (SecB.B063_MarStatAssign = WIDOWED);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN036_3 OBTAIN INS THRU HWP FORMER EMPLOYER- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N036_
Did [she/he] obtain this health insurance through [her/his] [former]
[spouse/partner]'s former employer?
.................................................................................
1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N033_HowObtIns <> YES;
IF N034_ <> YES;
IF (N035_ <> YES) AND (N036_ <> YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN037_3 WHERE PURCHASE PRIVATE PLAN INSURANCE- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N037_
Did [she/he] purchase this plan directly from an insurance company, through
[her/his] [or [her/his] [husband's/wife's/partner`s]/or your] union,
through a group such as AARP, a church, or other organization, or what?
.................................................................................
1 1. INSURANCE COMPANY
2. R`S UNION
3. SPOUSE`S UNION
1 4. GROUP
5. Former or deceased spouse's employer/union
6. Includes federal, state or military programs
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN039_3 PAY ALL/SOME/NONE PRIV PLAN HI COSTS-3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N039_PayHlthInsCost
Including any help from [her/his] family, did [she/he] [or/ or her/his]
[you/husband/wife/partner] pay all of the costs, some of the costs, or none of
the costs of the premium for this health insurance coverage?
.................................................................................
2 1. ALL
2. SOME
3. NONE
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN040_3 PRIV PLAN HI PAY PER/MONTH- AMT- 3
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.PlanDetails[3].N040_
How much did [she/he] [or/ or her/his] [you/husband/wife/partner] pay per month
in premiums for this plan?
[IWER: PROBE IF NECESSARY. Count any payroll deductions, but do not include any
amount paid by the employer]
IWER: DO NOT PROBE DK/RF
Amount per Month:
.................................................................................
1 11. Actual Value
1 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N041_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN041_3 PRIV PLAN HI PAY PER/MONTH- MIN- 3
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.PlanDetails[3].N041_
N041-N043 Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $50, $100, $150, $300, $500
RANDOM ENTRY POINTS: $100, $150, $300
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X515
.................................................................................
1 151. Value of Breakpoint
1309 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N042_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN042_3 PRIV PLAN HI PAY PER/MONTH- MAX- 3
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.PlanDetails[3].N042_
.................................................................................
1 99999996. Greater than Maximum Breakpoint
1309 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N043_ := EMPTY:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF N040_ <> EMPTY AND N040_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN043_3 PRIV PLAN HI PAY PER/MONTH- RESULT- 3
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[3].N043_
.................................................................................
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1309 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N044_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF piSecJWorkstatusJ021_EmpSelfOth = SLFEMPD);
*Assign N044_ := RISCURRLYSLFEMPD:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF piSecJWorkstatusJ021_EmpSelfOth = SLFEMPD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN044_3 BRANCHPNT-SELF EMPLOYED/ALL OTH- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N044_
.................................................................................
1. R IS CURRENTLY SELF-EMPLOYED
2 2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N046_ := INSTHRUCURFOREMPORUNION:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)));
*NOT(ELSE)*(IF N037_ = OTH_SPECIFY);
*Assign N046_ := INSTHRUSOMEPLACEELSEATR15:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF ((piRespondents1X065ACouplenss = MARRIED) OR
(piRespondents1X065ACouplenss = PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ =
YES)));
IF N037_ = OTH_SPECIFY;
*Assign N046_ := INSTHRUSPANDRISMDS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF ((piRespondents1X065ACouplenss = MARRIED) OR (piRespondents1X065ACouplenss =
PARTNERED_VOL)) AND ((N035_ = YES) OR (N036_ = YES));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN046_3 BRANCHPNT-SOURCE OF HEALTH INSURANCE- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N046_
.................................................................................
1. INS THRU SPOUSE AND R IS MARRIED, DIVORCED, OR SEPARATED
1 2. INS THRU SOMEPLACE ELSE
1 3. INS THRU CURRENT/FORMER EMPLOYER
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N047_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
*NOT(ELSE)*(IF piGovCoverN001_ = YES);
*Assign N047_ := RISCOVEREDBYMCARE:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N039_PayHlthInsCost <> NONE;
IF piGovCoverN001_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN047_3 BRANCHPNT-COVERD BY MEDICARE/ALL OTH- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N047_
.................................................................................
2 1. R IS COVERED BY MEDICARE
2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN052_3 PRIVATE PLAN INSURANCE AN HMO- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N052_Plan1HMO
Was this plan an hmo, that is, a health maintenance organization?
Def: (With an HMO, the cost of the physician visit is typically covered in
full or you pay only a small amount. All of your routine care must be provided
by an HMO physician.)
.................................................................................
1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN053_3 NUMBER YEARS IN PLAN- 3
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[3].N053_NumYrPlan
How long had [she/he] been with this plan?
Years:
Or
Months:
.................................................................................
1 30. Actual Value
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (N053_NumYrPlan = 0) OR N053_NumYrPlan = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN054_3 NUMBER MONTHS IN PLAN- 3
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PlanDetails[3].N054_NumMoPlan
How long has [she/he] been with this plan?
Years:
Or
Months:
.................................................................................
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1309 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF N052_Plan1HMO <> YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN055_3 PRIV PLAN HI- HAS LIST OF DRS- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N055_ListDoctor
Did this health insurance plan have a list or book of doctors that [she/he] was
encouraged or required to use?
.................................................................................
1. YES
1 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (N055_ListDoctor = YES) OR (N052_Plan1HMO = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN056_3 PLAN PAY FOR DOCTORS NOT ON LIST- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N056_DocNotList
Did [this health insurance plan/the HMO] pay any of the costs for routine care
if [she/he] saw a doctor who was not [on this list/in the HMO]?
.................................................................................
1. YES
2. YES, WITH A REFERRAL
5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1310 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N058_ := ALLOTHS:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns =
YES));
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N034_ = YES));
*Assign N058_ := HLTHINSFORMEREMPLESS65:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
*NOT(ELSE)*(IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns =
YES));
IF (piSecAContinuInterviewA019_RAge < 65) AND (N034_ = YES);
*Assign N058_ := HLTHINSFROMCUREMPLESS65:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
IF (piSecAContinuInterviewA019_RAge < 65) AND (N033_HowObtIns = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN058_3 PRIV HI FROM CUR/FOR EMP AND LESS 65- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N058_
.................................................................................
1. R HAS HEALTH INS FROM CURRENT EMPLOYER AND R IS LESS THAN 65
2. R HAS HEALTH INS FROM FORMER EMPLOYER AND R IS LESS THAN 65
2 3. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N023_ <> 0) AND N023_ <> NONRESPONSE;
IF CNT <= N023_;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN066_3 LIMITS ON HI DUE TO PREEXISTING COND- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PlanDetails[3].N066_LimitHlthIns
Were there any limits or restrictions on this health insurance plan due to a
preexisting condition?
.................................................................................
1. YES
1 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN071 LTC INSURANCE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeINs.N071_LTCIns
[Not including government programs, did] [FIRST NAME] have any long-term care
insurance which specifically covered nursing home care for a year or more or any
part of personal or medical care in [her/his] home?
.................................................................................
119 1. YES
1142 5. NO
45 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N072_LTCCovNHNewPrev := DIFFERENTPLAN:
IF N071_LTCIns = YES;
IF ptN090_NumOfPlans = 0;
ASK:
IF N071_LTCIns = YES;
*NOT(ELSE)*(IF ptN090_NumOfPlans = 0);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN072 LTC COV- NEW OR PRE MENTION PLAN
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeINs.N072_LTCCovNHNewPrev
Is that one of the plans you have already described, or a different plan?
.................................................................................
37 1. PREVIOUSLY DESCRIBED PLAN
78 2. DIFFERENT PLAN
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1191 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N073_LTCCovNHWhi := Plan27:
IF N071_LTCIns = YES;
IF ptN090_NumOfPlans = 0;
OR
IF N071_LTCIns = YES;
*NOT(ELSE)*(IF ptN090_NumOfPlans = 0);
*NOT(ELSE)*(IF N072_LTCCovNHNewPrev = PREVDESCRPLAN);
IF N072_LTCCovNHNewPrev = DIFFERENTPLAN;
ASK:
IF N071_LTCIns = YES;
*NOT(ELSE)*(IF ptN090_NumOfPlans = 0);
IF N072_LTCCovNHNewPrev = PREVDESCRPLAN;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN073 LTC COV- WHICH PREV MENTION PLAN
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeINs.N073_LTCCovNHWhi
Which plan is that?
.................................................................................
20 1. FIRST PLAN MENTIONED AT UN024
1 2. SECOND PLAN MENTIONED AT UN024
3. THIRD PLAN MENTIONED AT UN024
5 19. Medicare HMO
4 20. MEDICARE
21. MEDICAID
1 22. CHAMPUS
84 27. NOT ON LIST
98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1195 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N071_LTCIns = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN075 COVER NURSING HOME/IN-HOME CARE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeINs.N075_CovNHInHome
Did this plan cover care in a nursing home facility only, personal or long-term
care at home, or both in-home and nursing home care?
.................................................................................
21 1. NURSING HOME CARE ONLY
11 2. IN-HOME CARE ONLY
75 3. BOTH
7. OTHER (SPECIFY)
12 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1191 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N071_LTCIns = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN077 RECD BENEFITS UNDER LTC
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeINs.N077_RcvBenefLTC
Did [FIRST NAME] ever receive benefits under [her/his] long-term care policy?
.................................................................................
47 1. YES
71 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1191 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N071_LTCIns = YES;
IF (N072_LTCCovNHNewPrev <> PREVDESCRPLAN) OR (N073_LTCCovNHWhi = Plan27);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN079 AMT PAY FOR LTC
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.NHomeINs.N079_AmtPayLTC
How much did [he/she] (or [you/[his/her] [husband/wife/partner]]) pay for this
plan?
IWER: ENTER 0 IF NO PAYMENTS ARE MADE
IWER: DO NOT PROBE DK/RF
Amount:
Per:
.................................................................................
59 0-30000. Actual Value
29 999998. DK (Don't Know); NA (Not Ascertained)
999999. RF (Refused)
1222 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N071_LTCIns = YES;
IF (N072_LTCCovNHNewPrev <> PREVDESCRPLAN) OR (N073_LTCCovNHWhi = Plan27);
IF N079_AmtPayLTC > 0;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN083 AMT PAY FOR LTC PER
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeINs.N083_AmtPayLTCPer
How much did [she/he] pay per month for this plan?
IWER: ENTER 0 IF NO PAYMENTS ARE MADE
IWER: DO NOT PROBE DK/RF
Amount: [AMT PAY FOR LTC]
Per:
.................................................................................
23 1. MONTH
2. QUARTER (EVERY 3 MONTHS)
33 4. YEAR
1 6. Lump sum payment
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1253 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N080_ := EMPTY:
IF N071_LTCIns = YES;
IF (N072_LTCCovNHNewPrev <> PREVDESCRPLAN) OR (N073_LTCCovNHWhi = Plan27);
IF N079_AmtPayLTC <> EMPTY AND N079_AmtPayLTC <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN080 AMT PAY FOR LTC - MIN
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.NHomeINs.N080_
N080-N082 Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or what?
PROCEDURES: 2Up1Down, 1Up2Down
BREAKPOINTS: $50, $100, $200, $300
RANDOM ENTRY POINTS: $100, $200
ENTRY POINT ASSIGNMENT: 1 or {NOT 1} AT X502
.................................................................................
21 0. Value of Breakpoint
1 50. Value of Breakpoint
2 51. Value of Breakpoint
2 101. Value of Breakpoint
3 201. Value of Breakpoint
1281 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N081_ := EMPTY:
IF N071_LTCIns = YES;
IF (N072_LTCCovNHNewPrev <> PREVDESCRPLAN) OR (N073_LTCCovNHWhi = Plan27);
IF N079_AmtPayLTC <> EMPTY AND N079_AmtPayLTC <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN081 AMT PAY FOR LTC - MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.NHomeINs.N081_
.................................................................................
1 49. Value of Breakpoint
1 50. Value of Breakpoint
2 99. Value of Breakpoint
2 199. Value of Breakpoint
1 299. Value of Breakpoint
22 99999996. Greater than Maximum Breakpoint
1281 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N082_ := EMPTY:
IF N071_LTCIns = YES;
IF (N072_LTCCovNHNewPrev <> PREVDESCRPLAN) OR (N073_LTCCovNHWhi = Plan27);
IF N079_AmtPayLTC <> EMPTY AND N079_AmtPayLTC <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN082 AMT PAY FOR LTC- RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeINs.N082_
.................................................................................
22 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1288 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N090_NumOfPlans := N090_NumOfPlans + 1:
IF GovCover.N001_ = YES;
OR
IF GovCover.N006_ = YES;
OR
IF GovCover.N007_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN090 NUMBER OF PUBLIC/PRIVATE HI PLANS
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N090_NumOfPlans
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1310 0 4 1.76 0.71 0
-----------------------------------------------------------------
==========================================================================================
UN256 R AGE PREV INTERVIEW
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N256_RAgePREVIW
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1310 43 108 78.17 11.06 0
-----------------------------------------------------------------
==========================================================================================
ASK:
IF ((N090_NumOfPlans > 0) AND (piRvarsZ201_PWMedicareCovered <> YES)) OR
(N256_RAgePREVIW < 65);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN091 EVER WITHOUT HI AMONG CURRENTLY INSURED
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.N091_NoInsurance
Was [FIRST NAME] ever without health insurance coverage at any time [[since
[PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]]?
.................................................................................
34 1. YES
175 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1097 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N090_NumOfPlans = 0;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN342 CONFIRM NO MEDICAL INSURANCE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.N342_AnyInsurance
According to my information, [FIRST NAME] was not covered by any government or
private health insurance plans that provide medical care at the time of
[her/his] death.
Is that correct?
.................................................................................
32 1. YES
3 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
1270 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N090_NumOfPlans = 0;
IF N342_AnyInsurance = NO;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN343M1 WHICH PLAN-1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.N343_WhatInsurance[1]
Under which of the following plans was [she/he] covered?
READ list:
Medicare
Medicaid
Champus/ChampVA
A private plan from an employer
A private plan purchased directly
Some other type of plan
IWER: CHOOSE ALL THAT APPLY.
IWER: IF REPORTED STATE NAME FOR MEDICAID, CODE AS 2. MEDICAID.
.................................................................................
1. MEDICARE
2. MEDICAID
3. CHAMPUS/CHAMPVA
1 4. A PRIVATE PLAN FROM AN EMPLOYER
5. A PRIVATE PLAN PURCHASED DIRECTLY
1 6. OTHER PLAN
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1307 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N090_NumOfPlans = 0;
IF N342_AnyInsurance = NO;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN343M2 WHICH PLAN-2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.N343_WhatInsurance[2]
Under which of the following plans was [she/he] covered?
READ list:
Medicare
Medicaid
Champus/ChampVA
A private plan from an employer
A private plan purchased directly
Some other type of plan
IWER: CHOOSE ALL THAT APPLY.
IWER: IF REPORTED STATE NAME FOR MEDICAID, CODE AS 2. MEDICAID.
.................................................................................
1. MEDICARE
2. MEDICAID
3. CHAMPUS/CHAMPVA
4. A PRIVATE PLAN FROM AN EMPLOYER
5. A PRIVATE PLAN PURCHASED DIRECTLY
6. OTHER PLAN
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1310 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
(SecA.ContinuInterview.A124_PlaceDied = INHOSPITAL);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN301 TIME IN HOSPITAL BEFORE DEATH
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.N301_
The next questions are about health care [she/he] had received.
Earlier you told me that [FIRST NAME] died while in a hospital. How long had
[she/he] been a patient in that hospital before [her/his] death?
IWER: ENTER `1 HOUR` IF LESS THAN ONE HOUR.
Number:
.................................................................................
491 1-318. Actual Value
7 998. DK (Don't Know); NA (Not Ascertained)
1 999. RF (Refused)
811 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
(SecA.ContinuInterview.A124_PlaceDied = INHOSPITAL);
IF N301_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN302 TIME IN HOSPITAL BEFORE DEATH- UNIT
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.N302_
The next questions are about health care [she/he] had received. Earlier you told
me that [FIRST NAME] died while in a hospital. How long had [she/he] been a
patient in that hospital before [her/his] death?
ENTER `1 hour` if less than one hour
Unit:
.................................................................................
53 1. HOURS
322 2. DAYS
86 3. WEEKS
28 4. MONTHS
2 5. YEARS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
819 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
(SecA.ContinuInterview.A124_PlaceDied = INHOSPITAL);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN303 REASON IN HOSPITAL
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.N303_
Why had [she/he] been admitted to the hospital? Was it to have surgery, receive
other treatments, relieve [her/his] symptoms, or what?
.................................................................................
43 1. SURGERY
194 2. OTHER TREATMENTS
226 3. RELIEVE SYMPTOMS
26 7. OTHER (SPECIFY)
9 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
811 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN099 OVERNIGHT STAY IN HOSP-SINCE PREV IW/2YR
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HospitalStay.N099_OverniteHosp
IF R DIED IN HOSPITAL (A124=1):
In addition to that hospital stay, [since [PREV WAVE FIRST R IW MONTH], [PREV
WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev
Wave Iw Yr]/in the two years before [her/his] death]/ had [she/he] been a
patient in a hospital overnight?
OTHERWISE:
The next questions are about health care [she/he] had received. [Since [PREV
WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/ Since
[PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/In the two years before [her/his]
death]] had [she/he] been a patient in a hospital overnight?
.................................................................................
876 1. YES
416 5. NO
14 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N100_TimeOverHosp := 1:
IF (((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) AND
(PISecAContinuInterviewA124_PlaceDied = INHOSPITAL)) AND (N099_OverniteHosp <>
YES);
ASK:
IF N099_OverniteHosp = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN100 NUM TIMES R STAYED OVERNIGHT IN HOSP
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.HospitalStay.N100_TimeOverHosp
[Including [her/his] final hospitalization,] How many different times was
[she/he] a patient in a hospital overnight ([[since [PREV WAVE FIRST R IW
Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/since [PREV WAVE FIRST R
IW YEAR]/[Prev Wave Iw Yr]/in the last two years before her/his death]])?
IWER: IF PROXY ASKS, INCLUDE MENTAL HOSPITALS AND SANITARIUMS
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1029 0 40 2.75 3.05 226
-----------------------------------------------------------------
55 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
IF N099_OverniteHosp = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN101 NUM NIGHTS R SPENT OVERNIGHT IN HOSPITAL
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.HospitalStay.N101_NiteOverHosp
[Altogether how/How] many nights was [she/he] a patient in a hospital ([[since
[PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]])?
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
777 0 353 21.38 31.91 434
-----------------------------------------------------------------
99 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
==========================================================================================
ASK:
((N100_TimeOverHosp <> 0) AND N100_TimeOverHosp <> EMPTY);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN305 SPEND TIME IN ICU
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HospitalStay.N305_
[During any of those hospital stays /During [her/his] hospital stay ] did [FIRST
NAME] spend any time in an intensive care unit?
.................................................................................
513 1. YES
494 5. NO
18 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
284 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
((N100_TimeOverHosp <> 0) AND N100_TimeOverHosp <> EMPTY);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN306 USED LIFE SUPPORT
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HospitalStay.N306_
([During any of those hospital stays /During [her/his] hospital stay ]) did
[she/he] use life support equipment, such as a respirator?
.................................................................................
319 1. YES
691 5. NO
15 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
284 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
((N100_TimeOverHosp <> 0) AND N100_TimeOverHosp <> EMPTY);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN307 USED KIDNEY DIALYSIS SERVICES
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HospitalStay.N307_
([During any of those hospital stays /During [her/his] hospital stay ]) did
[she/he] use kidney dialysis services?
.................................................................................
70 1. YES
948 5. NO
7 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
284 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
((N100_TimeOverHosp <> 0) AND N100_TimeOverHosp <> EMPTY);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN308 RECEIVE ANTIBIOTICS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HospitalStay.N308_
([During any of those hospital stays /During [her/his] hospital stay ]) did
[she/he] receive antibiotics to treat pneumonia or other infection?
.................................................................................
593 1. YES
338 5. NO
94 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
284 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N099_OverniteHosp = YES) OR (PISecAContinuInterviewA124_PlaceDied =
INHOSPITAL);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN102 HOSPITAL STAYS COVERED BY INS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HospitalStay.N102_HospCovIns
Were the costs for [her/his] hospital stay(s) completely covered by health
insurance,mostly covered, only partially covered, or not covered at all by
insurance?
.................................................................................
665 1. COMPLETELY COVERED
274 2. MOSTLY COVERED
61 3. PARTIALLY COVERED
19 5. NOT COVERED AT ALL
22 7. [VOL] COSTS NOT SETTLED YET
41 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
227 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (N099_OverniteHosp = YES) OR (PISecAContinuInterviewA124_PlaceDied =
INHOSPITAL);
IF N102_HospCovIns <> COMPLETELYCOVRD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN106 AMT PAID O-O-P HOSPITAL COSTS
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.HospitalStay.N106_AmtOOPHospCost
About how much did [she/he] pay out-of-pocket for hospital bills [since [PREV
WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/since
[PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the two years before [her/his]
death]?
IWER: DO NOT PROBE DK/RF
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
165 15 140000 3758.11 11890.17 892
-----------------------------------------------------------------
35 0. None; includes cost not settled yet
214 9999998. DK (Don't Know); NA (Not Ascertained)
4 9999999. RF (Refused)
==========================================================================================
*Assign N107_ := EMPTY:
IF (N099_OverniteHosp = YES) OR (PISecAContinuInterviewA124_PlaceDied =
INHOSPITAL);
IF N102_HospCovIns <> COMPLETELYCOVRD;
IF N106_AmtOOPHospCost <> EMPTY AND N106_AmtOOPHospCost <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN107 AMT PAID O-O-P HOSPITAL COSTS - MIN
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.HospitalStay.N107_
N107-N109 Unfolding Sequence
Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $500, $5,000, $10,000, $20,000, $50,000
RANDOM ENTRY POINTS: $5,000, $10,000, $20,000
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X511
.................................................................................
97 0. Value of Breakpoint
7 500. Value of Breakpoint
43 501. Value of Breakpoint
7 5000. Value of Breakpoint
19 5001. Value of Breakpoint
6 10000. Value of Breakpoint
34 10001. Value of Breakpoint
1 20000. Value of Breakpoint
2 20001. Value of Breakpoint
1 50000. Value of Breakpoint
1 50001. Value of Breakpoint
1092 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N108_ := EMPTY:
IF (N099_OverniteHosp = YES) OR (PISecAContinuInterviewA124_PlaceDied =
INHOSPITAL);
IF N102_HospCovIns <> COMPLETELYCOVRD;
IF N106_AmtOOPHospCost <> EMPTY AND N106_AmtOOPHospCost <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN108 AMT PAID O-O-P HOSPITAL COSTS - MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.HospitalStay.N108_
.................................................................................
25 499. Value of Breakpoint
7 500. Value of Breakpoint
48 4999. Value of Breakpoint
7 5000. Value of Breakpoint
24 9999. Value of Breakpoint
6 10000. Value of Breakpoint
10 19999. Value of Breakpoint
1 20000. Value of Breakpoint
2 49999. Value of Breakpoint
1 50000. Value of Breakpoint
87 99999996. Greater than Maximum Breakpoint
1092 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N109_ := EMPTY:
IF (N099_OverniteHosp = YES) OR (PISecAContinuInterviewA124_PlaceDied =
INHOSPITAL);
IF N102_HospCovIns <> COMPLETELYCOVRD;
IF N106_AmtOOPHospCost <> EMPTY AND N106_AmtOOPHospCost <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN109 AMT PAID O-O-P HOSPITAL COSTS - RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.HospitalStay.N109_
.................................................................................
99 98. DK (Don't Know); NA (Not Ascertained)
3 99. RF (Refused)
1208 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign HospitalStay.N250_PlanCnt2 := N090_NumOfPlans:
IF (HospitalStay.N099_OverniteHosp <> EMPTY OR HospitalStay.N113_ExpNamePlanHosp
<> EMPTY) AND HospitalStay.N250_PlanCnt2 = EMPTY;
*Assign N250_PlanCnt2 := ptN090_NumOfPlans:
IF N113_ExpNamePlanHosp <> EMPTY AND N250_PlanCnt2 = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN250 PLAN COUNT 2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.HospitalStay.N250_PlanCnt2
User Note: This value is assigned from N090 where N099 or N113 is blank.
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1307 0 4 1.76 0.71 3
-----------------------------------------------------------------
==========================================================================================
ASK:
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) OR
(SecA.ContinuInterview.A124_PlaceDied = INNURSINGHOME));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN309 NURSING HOME B/F DEATH- DAYS
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.NHomeStay.N309_
Earlier you told me that [FIRST NAME] [ died while/was living ] in a nursing
home. How long had [she/he] been a patient in that nursing home before [her/his]
death?
# days:
Or
# Months:
Or
# Years:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
122 1 180 18.23 22.18 1181
-----------------------------------------------------------------
7 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
==========================================================================================
ASK:
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) OR
(SecA.ContinuInterview.A124_PlaceDied = INNURSINGHOME));
IF (N309_ = DONTKNOW) OR N309_ = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN310 NURSING HOME B/F DEATH- MONTHS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.N310_
Earlier you told me that [FIRST NAME] [ died while/was living ] in a nursing
home. How long had [she/he] been a patient in that nursing home before [her/his]
death?
# Days:
Or
# Months:
Or
# Years:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
144 1 32 6.24 5.93 1160
-----------------------------------------------------------------
6 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) OR
(SecA.ContinuInterview.A124_PlaceDied = INNURSINGHOME));
IF (N309_ = DONTKNOW) OR N309_ = EMPTY;
IF (N310_ = DONTKNOW) OR N310_ = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN257 NURSING HOME B/F DEATH- YEARS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.N257_
Earlier you told me that [FIRST NAME] [ died while/was living ] in a nursing
home. How long had [she/he] been a patient in that nursing home before [her/his]
death?
# Days:
Or
# Months:
Or
# Years:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
132 1 14 3.69 2.48 1172
-----------------------------------------------------------------
6 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) OR
(SecA.ContinuInterview.A124_PlaceDied = INNURSINGHOME));
IF (N309_ = DONTKNOW) OR N309_ = EMPTY;
IF (N310_ = DONTKNOW) OR N310_ = EMPTY;
IF N257_ <> REFUSAL;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN258 YEAR ENTERED NURSING HOME
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.NHomeStay.N258_
In what year did [she/he] go into the nursing home or health care facility?
Year:
.................................................................................
132 1992-2005. Actual Value
9 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
1169 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) OR
(SecA.ContinuInterview.A124_PlaceDied = INNURSINGHOME));
IF (N309_ = DONTKNOW) OR N309_ = EMPTY;
IF (N310_ = DONTKNOW) OR N310_ = EMPTY;
IF N257_ <> REFUSAL;
IF N258_ >= Init.A062T2YrsAgo_A;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN259 MONTH ENTERED NURSING HOME
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.N259_
What month was that?
Month:
.................................................................................
1. JAN
1 2. FEB
1 3. MAR
2 4. APR
2 5. MAY
3 6. JUN
3 7. JUL
2 8. AUG
1 9. SEP
1 10. OCT
1 11. NOV
3 12. DEC
5 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1285 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN314M1M WHY ADMITTED - FINAL- 1- MASKED
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.NHomeStay.N314_
Why had [he/she] been admitted to the nursing home?
User note: See Health Conditions Master Code for detailed codes. Some
categories have been collapsed to protect respondent confidentiality:
113-117=119, 181-183=189, 190-196=997.
.................................................................................
18 101-103. Cancers and tumors; skin conditions
29 111-119. Musculoskeletal system and connective tissue
34 121-129. Heart, circulatory and blood conditions
14 131-139. Allergies; hay fever; sinusitis; tonsillitis
4 141-149. Endocrine, metabolic and nutritional conditions
11 151-159. Digestive system (stomach, liver, gallbladder,
kidney, bladder)
16 161-169. Neurological and sensory conditions
171-179. Digestive system (stomach, liver, gallbladder,
kidney, bladder)
2 181-189. Neurological and sensory conditions
191-196. Miscellaneous
6 595-597. Other symptoms
105 701. No other care arrangements available
72 702. Deteriorating health; health condition not
specified
17 703. To recover/rehab for injury/surgery
990. No text displayed
996. None
67 997. Other health condition
11 998. DK (Don’t Know); NA (Not Ascertained)
999. RF (Refused)
904 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN314M2M WHY ADMITTED - FINAL- 2- MASKED
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.NHomeStay.N314_
Why had [he/she] been admitted to the nursing home?
User note: See Health Conditions Master Code for detailed codes. Some
categories have been collapsed to protect respondent confidentiality:
113-117=119, 181-183=189, 190-196=997.
.................................................................................
1 101-103. Cancers and tumors; skin conditions
10 111-119. Musculoskeletal system and connective tissue
13 121-129. Heart, circulatory and blood conditions
1 131-139. Allergies; hay fever; sinusitis; tonsillitis
5 141-149. Endocrine, metabolic and nutritional conditions
6 151-159. Digestive system (stomach, liver, gallbladder,
kidney, bladder)
5 161-169. Neurological and sensory conditions
171-179. Digestive system (stomach, liver, gallbladder,
kidney, bladder)
1 181-189. Neurological and sensory conditions
191-196. Miscellaneous
7 595-597. Other symptoms
39 701. No other care arrangements available
16 702. Deteriorating health; health condition not
specified
6 703. To recover/rehab for injury/surgery
990. No text displayed
996. None
30 997. Other health condition
998. DK (Don’t Know); NA (Not Ascertained)
999. RF (Refused)
1170 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN114 EVER PATIENT OVERNIGHT IN NURSING HOME
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.N114_OverniteNH
[Other than this nursing home stay and excluding / Excluding ] any hospice
stays, ([[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev
Wave Iw Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two
years before her/his death]]), had [she/he] been a patient overnight in a
nursing home, convalescent home, or other long-term health care facility?
.................................................................................
231 1. YES
1071 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N115_TimeOverNH := 1:
IF (((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) AND
((PISecAContinuInterviewA124_PlaceDied = INNURSINGHOME) OR
(SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME))) AND (N114_OverniteNH <>
YES);
ASK:
*NOT(ELSE)*(IF (((ACTIVELANGUAGE = EXTENG) OR (ACTIVELANGUAGE = EXTSPN)) AND
((PISecAContinuInterviewA124_PlaceDied = INNURSINGHOME) OR
(SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME))) AND (N114_OverniteNH <>
YES));
IF N114_OverniteNH = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN115 # TIMES SPENT OVERNIGHT IN NURSING HOME
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.N115_TimeOverNH
[Including [her/his] final stay, how/How] many different times was [she/he] a
patient in a nursing home or other long-term care facility [[since [PREV WAVE
FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/since [PREV
WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years before her/his
death]]?
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
550 1 70 1.51 3.68 755
-----------------------------------------------------------------
5 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
IF N114_OverniteNH = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN116 NUM NIGHTS R SPENT OVERNIGHT IN NH
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.NHomeStay.N116_NiteOverNH
[Altogether, how/How] many nights or months has [she/he] been a patient in a
nursing home [[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW
YEAR]/[Prev Wave Iw Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in
the last two years before her/his death]]?
IWER: ENTER 996 FOR CONTINUOUS SINCE ENTERED OR [[SINCE [PREV WAVE FIRST R IW
MONTH], [PREV WAVE FIRST R IW YEAR]/[PREV WAVE IW YR]/SINCE [PREV WAVE FIRST R
IW YEAR]/[PREV WAVE IW YR]/IN THE LAST TWO YEARS BEFORE HER/HIS DEATH]]
IWER: IF R ANSWERS IN MONTHS RATHER THAN NIGHTS, PRESS ENTER AND ANSWER IN
MONTH FIELD
Nights:
Or
Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
134 0 300 35.02 51.21 1144
-----------------------------------------------------------------
17 996. CONTINUOUS SINCE ENTERED
15 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
==========================================================================================
ASK:
IF N114_OverniteNH = YES;
IF N116_NiteOverNH = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN117 NUM MOS R SPENT OVERNIGHT IN NH
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.N117_MoOverNH
[Altogether, how/How] many nights or months was [she/he] a patient in a
nursing home [[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW
YEAR]/[Prev Wave Iw Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in
the last two years before her/his death]]?
Nights:
Or
Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
64 1 36 7.44 7.40 1245
-----------------------------------------------------------------
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN118 NH COSTS COVERED BY INSURANCE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.N118_InsCovCost
[Were the costs for [her/his] nursing home stay(s) completely covered by]
insurance, mostly covered, only partially covered, or not covered at all by
insurance?
.................................................................................
265 1. COMPLETELY COVERED
89 2. MOSTLY COVERED
76 3. PARTIALLY COVERED
87 5. NOT COVERED AT ALL
9 7. [VOL] COSTS NOT SETTLED YET
27 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
757 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF N118_InsCovCost <> COMPLETELYCOVRD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN119 AMT PAID O-O-P NURSING HOME
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.NHomeStay.N119_AmtPayNHHosp
About how much did [she/he] pay out-of-pocket for nursing home bills [[since
[PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]]?
IWER: DO NOT PROBE DK/RF
IWER: INCLUDE ANY AMOUNT PAID BY OTHERS
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
166 30 328000 17540.99 35750.92 1022
-----------------------------------------------------------------
22 0. None; includes cost not settled yet
99 9999998. DK (Don't Know); NA (Not Ascertained)
1 9999999. RF (Refused)
==========================================================================================
*Assign N120_ := EMPTY:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF N118_InsCovCost <> COMPLETELYCOVRD;
IF N119_AmtPayNHHosp <> EMPTY AND N119_AmtPayNHHosp <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN120 AMT PAID O-O-P NURSING HOME- MIN
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.NHomeStay.N120_
N120-N122 Unfolding Sequence
Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $500, $5,000, $10,000, $20,000, $50,000
RANDOM ENTRY POINTS: $5,000, $10,000, $20,000
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X512
.................................................................................
32 0. Value of Breakpoint
1 500. Value of Breakpoint
11 501. Value of Breakpoint
4 5000. Value of Breakpoint
8 5001. Value of Breakpoint
2 10000. Value of Breakpoint
26 10001. Value of Breakpoint
4 20001. Value of Breakpoint
4 50000. Value of Breakpoint
7 50001. Value of Breakpoint
1211 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N121_ := EMPTY:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF N118_InsCovCost <> COMPLETELYCOVRD;
IF N119_AmtPayNHHosp <> EMPTY AND N119_AmtPayNHHosp <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN121 AMT PAID O-O-P NURSING HOME- MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.NHomeStay.N121_
.................................................................................
7 499. Value of Breakpoint
1 500. Value of Breakpoint
12 4999. Value of Breakpoint
4 5000. Value of Breakpoint
7 9999. Value of Breakpoint
2 10000. Value of Breakpoint
2 19999. Value of Breakpoint
4 49999. Value of Breakpoint
4 50000. Value of Breakpoint
56 99999996. Greater than Maximum Breakpoint
1211 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N122_ := EMPTY:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF N118_InsCovCost <> COMPLETELYCOVRD;
IF N119_AmtPayNHHosp <> EMPTY AND N119_AmtPayNHHosp <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN122 AMT PAID O-O-P NURSING HOME- RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.N122_
.................................................................................
1 97. Data not available
50 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
1258 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN124_1 YEAR R MOVED TO NURSING HOME -1
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N124_YrMovInNH1
[Think back to the first/second/last time [in the last two years/since [PREV
WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that
[she/he] was a patient in a nursing home or other long-term care facility./Think
back to the first/second/last/ time [in the last two years/since [PREV WAVE
FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that [she/he]
was a patient in a nursing home or other long-term care facility./Think about
[her/his] last stay at the nursing home or other long-term care facility.]
In what year did [she/he] go into the nursing home or health care facility?
Year:
.................................................................................
184 1999-2006. Actual Value
4 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
1122 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF N124_YrMovInNH1 >= Init.A062T2YrsAgo_A;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN123_1 MONTH R MOVED TO NURSING HOME -1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N123_MoMovInNH1
(What month was that?)
Month:
.................................................................................
8 1. JAN
7 2. FEB
20 3. MAR
12 4. APR
8 5. MAY
10 6. JUN
15 7. JUL
9 8. AUG
18 9. SEP
19 10. OCT
14 11. NOV
8 12. DEC
2 13. WINTER
4 14. SPRING
2 15. SUMMER
3 16. FALL
13 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1138 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF (SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) OR
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) AND (piLPCNTR <
piN115_TimeOverNH));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN126_1 YEAR R MOVED OUT OF NURSING HOME -1
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N126_YrMovOutNH1
In what year did [she/he] move out of the nursing home or health care facility?
Year:
.................................................................................
180 2001-2006. Actual Value
5 9995. Continuous since entered; R still in nursing
home
3 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
1122 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF (SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) OR
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) AND (piLPCNTR <
piN115_TimeOverNH));
IF N126_YrMovOutNH1 >= Init.A062T2YrsAgo_A;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN125_1 MONTH R MOVED OUT OF NURSING HOME -1
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N125_MoMovOutNH1
(What month was that?)
Month:
.................................................................................
10 1. JAN
9 2. FEB
16 3. MAR
10 4. APR
15 5. MAY
7 6. JUN
18 7. JUL
10 8. AUG
14 9. SEP
10 10. OCT
18 11. NOV
15 12. DEC
1 13. WINTER
1 14. SPRING
4 15. SUMMER
2 16. FALL
14 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1136 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN127_1 ELIGIBLE FOR MEDICAID START NH STAY- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N127_
[Think back to the first/second/last time [in the last two years/since [PREV
WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that
[she/he] was a patient in a nursing home or other long-term care facility./Think
back to the first/second/last/ time [in the last two years/since [PREV WAVE
FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that [she/he]
was a patient in a nursing home or other long-term care facility./Think about
[her/his] last stay at the nursing home or other long-term care facility.]
Was [FIRST NAME] eligible for (Medicaid/State name for Medicaid) at the time
[her/his] [first/second/last] nursing home stay started?
.................................................................................
162 1. YES
28 5. NO
8 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1112 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF N127_ = NO;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN128_1 ELIGIBLE FOR MEDICAID DURNG NH STAY- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N128_
Did [she/he] become eligible for (Medicaid/State name for Medicaid) during that
nursing home stay?
.................................................................................
17 1. YES
11 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1282 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N129_ := ALLOTHS:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
*NOT(ELSE)*(IF piN115_TimeOverNH > 1);
*Assign N129_ := RHADMORETHAN1STAYINNHOMESINCELA:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF piN115_TimeOverNH > 1;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN129_1 BRNCHPNT-MORE THAN 1 NH STAY/ALL OTH- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N129_
.................................................................................
31 1. R HAD MORE THAN 1 STAY IN NURSING HOME SINCE LAST WAVE
167 2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1112 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF (((N127_ = YES) OR (N128_ = YES)) AND (((piN115_TimeOverNH <= 3) AND
(piLPCNTR = piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR = 3)))) AND
((PISecARelationsA028_RInNHome = NO) AND (PISecAContinuInterviewA124_PlaceDied
<> INNURSINGHOME));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN130_1 LOSE ELIGIBILITY-LAST NH STAY- 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N130_
Did [she/he] lose [her/his] eligibility for (Medicaid/State name for Medicaid)
when [she/he] was discharged from [her/his] (last) nursing home stay?
.................................................................................
1 1. YES
16 5. NO
1 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1292 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_TimeOverNH) AND (piLPCNTR <> 3))) OR
((((piLPCNTR = piN115_TimeOverNH) OR (piLPCNTR = 3)) AND
(SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME)) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN131_1 WHERE R LIVE AFTER NURSING HOME STAY -1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N131_LiveAftNH1
Where did [she/he] live after leaving the nursing home or health care facility?
(Did [she/he] live alone,[with you only,/with [her/his][husband/wife/partner]
only,] with one of [her/his] children and his or her own family, with other
relatives, in a retirement center, or what?)
.................................................................................
32 1. R LIVED BY HIM/HER SELF, ALONE
37 2. R LIVED WITH SPOUSE/PARTNER ONLY
28 3. R LIVED WITH CHILD AND CHILD'S FAMILY
5 4. R LIVED WITH OTHER RELATIVE(S)
2 5. R LIVED IN RETIREMENT CENTER
78 6. ANOTHER NURSING HOME, HOSPITAL,ASSISTED LIVING, REHAB CENTER
8 7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1120 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N133_WhiChldNH1 := DONTKNOW:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_TimeOverNH) AND (piLPCNTR <> 3))) OR
((((piLPCNTR = piN115_TimeOverNH) OR (piLPCNTR = 3)) AND
(SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME)) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME));
IF N131_LiveAftNH1 = RLIVEDWITHCHILDCHILDSFAM;
*NOT(ELSE)*(IF N255_N133_WhiChldNH1_A <> NONRESPONSE);
IF N255_N133_WhiChldNH1_A = DONTKNOW;
*Assign N133_WhiChldNH1 := REFUSAL:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_Tim
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN133_1 LIVE WITH WHICH CHILD AFTER NH STAY -1
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[1].N133_WhiChldNH1
(Which child was that?)
If grandchild: (which of [her/his] children is the parent of that grandchild?)
.................................................................................
28 041-990. Other Person Number
992. DECEASED CHILD
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1282 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN124_2 YEAR R MOVED TO NURSING HOME -2
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N124_YrMovInNH1
[Think back to the first/second/last time [in the last two years/since [PREV
WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that
[she/he] was a patient in a nursing home or other long-term care facility./Think
back to the first/second/last/ time [in the last two years/since [PREV WAVE
FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that [she/he]
was a patient in a nursing home or other long-term care facility./Think about
[her/his] last stay at the nursing home or other long-term care facility.]
In what year did [she/he] go into the nursing home or health care facility?
Year:
.................................................................................
50 2002-2006. Actual Value
3 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
1257 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF N124_YrMovInNH1 >= Init.A062T2YrsAgo_A;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN123_2 MONTH R MOVED TO NURSING HOME -2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N123_MoMovInNH1
(What month was that?)
Month:
.................................................................................
4 1. JAN
4 2. FEB
6 3. MAR
1 4. APR
5 5. MAY
1 6. JUN
1 7. JUL
4 8. AUG
7 9. SEP
2 10. OCT
2 11. NOV
3 12. DEC
3 13. WINTER
14. SPRING
15. SUMMER
1 16. FALL
4 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1262 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF (SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) OR
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) AND (piLPCNTR <
piN115_TimeOverNH));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN126_2 YEAR R MOVED OUT OF NURSING HOME -2
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N126_YrMovOutNH1
In what year did [she/he] move out of the nursing home or health care facility?
Year:
.................................................................................
50 2002-2006. Actual Value
9995. Continuous since entered; R still in nursing
home
3 9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
1257 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF (SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) OR
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) AND (piLPCNTR <
piN115_TimeOverNH));
IF N126_YrMovOutNH1 >= Init.A062T2YrsAgo_A;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN125_2 MONTH R MOVED OUT OF NURSING HOME -2
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N125_MoMovOutNH1
(What month was that?)
Month:
.................................................................................
3 1. JAN
2 2. FEB
7 3. MAR
3 4. APR
3 5. MAY
3 6. JUN
1 7. JUL
3 8. AUG
3 9. SEP
4 10. OCT
5 11. NOV
3 12. DEC
1 13. WINTER
2 14. SPRING
1 15. SUMMER
1 16. FALL
3 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1262 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN127_2 ELIGIBLE FOR MEDICAID START NH STAY- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N127_
[Think back to the first/second/last time [in the last two years/since [PREV
WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that
[she/he] was a patient in a nursing home or other long-term care facility./Think
back to the first/second/last/ time [in the last two years/since [PREV WAVE
FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that [she/he]
was a patient in a nursing home or other long-term care facility./Think about
[her/his] last stay at the nursing home or other long-term care facility.]
Was [FIRST NAME] eligible for (Medicaid/State name for Medicaid) at the time
[her/his] [first/second/last] nursing home stay started?
.................................................................................
24 1. YES
4 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1278 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF N127_ = NO;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN128_2 ELIGIBLE FOR MEDICAID DURNG NH STAY- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N128_
Did [she/he] become eligible for (Medicaid/State name for Medicaid) during that
nursing home stay?
.................................................................................
2 1. YES
2 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1306 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N129_ := ALLOTHS:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
*NOT(ELSE)*(IF piN115_TimeOverNH > 1);
*Assign N129_ := RHADMORETHAN1STAYINNHOMESINCELA:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF piN115_TimeOverNH > 1;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN129_2 BRNCHPNT-MORE THAN 1 NH STAY/ALL OTH-2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N129_
.................................................................................
32 1. R HAD MORE THAN 1 STAY IN NURSING HOME SINCE LAST WAVE
2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1278 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF (((N127_ = YES) OR (N128_ = YES)) AND (((piN115_TimeOverNH <= 3) AND
(piLPCNTR = piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR = 3)))) AND
((PISecARelationsA028_RInNHome = NO) AND (PISecAContinuInterviewA124_PlaceDied
<> INNURSINGHOME));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN130_2 LOSE ELIGIBILITY-LAST NH STAY- 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N130_
Did [she/he] lose [her/his] eligibility for (Medicaid/State name for Medicaid)
when [she/he] was discharged from [her/his] (last) nursing home stay?
.................................................................................
1 1. YES
3 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1306 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_TimeOverNH) AND (piLPCNTR <> 3))) OR
((((piLPCNTR = piN115_TimeOverNH) OR (piLPCNTR = 3)) AND
(SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME)) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN131_2 WHERE R LIVE AFTER NURSING HOME STAY -2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N131_LiveAftNH1
Where did [she/he] live after leaving the nursing home or health care facility?
(Did [she/he] live alone,[with you only,/with [her/his][husband/wife/partner]
only,] with one of [her/his] children and his or her own family, with other
relatives, in a retirement center, or what?)
.................................................................................
8 1. R LIVED BY HIM/HER SELF, ALONE
14 2. R LIVED WITH SPOUSE/PARTNER ONLY
10 3. R LIVED WITH CHILD AND CHILD'S FAMILY
1 4. R LIVED WITH OTHER RELATIVE(S)
5. R LIVED IN RETIREMENT CENTER
18 6. ANOTHER NURSING HOME, HOSPITAL,ASSISTED LIVING, REHAB CENTER
4 7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1255 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N133_WhiChldNH1 := DONTKNOW:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_TimeOverNH) AND (piLPCNTR <> 3))) OR
((((piLPCNTR = piN115_TimeOverNH) OR (piLPCNTR = 3)) AND
(SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME)) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME));
IF N131_LiveAftNH1 = RLIVEDWITHCHILDCHILDSFAM;
*NOT(ELSE)*(IF N255_N133_WhiChldNH1_A <> NONRESPONSE);
IF N255_N133_WhiChldNH1_A = DONTKNOW;
*Assign N133_WhiChldNH1 := REFUSAL:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_Tim
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN133_2 LIVE WITH WHICH CHILD AFTER NH STAY -2
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[2].N133_WhiChldNH1
(Which child was that?)
If grandchild: (which of [her/his] children is the parent of that grandchild?)
.................................................................................
10 041-990. Other Person Number
992. DECEASED CHILD
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1300 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN124_3 YEAR R MOVED TO NURSING HOME -3
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N124_YrMovInNH1
[Think back to the first/second/last time [in the last two years/since [PREV
WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that
[she/he] was a patient in a nursing home or other long-term care facility./Think
back to the first/second/last/ time [in the last two years/since [PREV WAVE
FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that [she/he]
was a patient in a nursing home or other long-term care facility./Think about
[her/his] last stay at the nursing home or other long-term care facility.]
In what year did [she/he] go into the nursing home or health care facility?
Year:
.................................................................................
19 2002-2006. Actual Value
9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
1291 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF N124_YrMovInNH1 >= Init.A062T2YrsAgo_A;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN123_3 MONTH R MOVED TO NURSING HOME -3
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N123_MoMovInNH1
(What month was that?)
Month:
.................................................................................
3 1. JAN
1 2. FEB
1 3. MAR
2 4. APR
3 5. MAY
6. JUN
2 7. JUL
8. AUG
2 9. SEP
10. OCT
2 11. NOV
12. DEC
1 13. WINTER
14. SPRING
15. SUMMER
16. FALL
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1292 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF (SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) OR
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) AND (piLPCNTR <
piN115_TimeOverNH));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN126_3 YEAR R MOVED OUT OF NURSING HOME -3
Section: N Level: Respondent Type: Numeric Width: 4 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N126_YrMovOutNH1
In what year did [she/he] move out of the nursing home or health care facility?
Year:
.................................................................................
16 2002-2006. Actual Value
3 9995. Continuous since entered; R still in nursing
home
9998. DK (Don't Know); NA (Not Ascertained)
9999. RF (Refused)
1291 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)) OR ((piN115_TimeOverNH
> 1) AND piN115_TimeOverNH <> NONRESPONSE)) AND ((piX008AInNHome_V <>
INNURSINGHOME) OR (piN116_NiteOverNH <> 996))) AND ((((piN115_TimeOverNH <= 3)
AND (piLPCNTR < piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR < 3))) OR
((SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME)));
IF (SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME) OR
((SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME) AND (piLPCNTR <
piN115_TimeOverNH));
IF N126_YrMovOutNH1 >= Init.A062T2YrsAgo_A;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN125_3 MONTH R MOVED OUT OF NURSING HOME -3
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N125_MoMovOutNH1
(What month was that?)
Month:
.................................................................................
1 1. JAN
1 2. FEB
2 3. MAR
2 4. APR
2 5. MAY
1 6. JUN
1 7. JUL
8. AUG
1 9. SEP
10. OCT
1 11. NOV
2 12. DEC
13. WINTER
14. SPRING
15. SUMMER
16. FALL
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1295 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN127_3 ELIGIBLE FOR MEDICAID START NH STAY- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N127_
[Think back to the first/second/last time [in the last two years/since [PREV
WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that
[she/he] was a patient in a nursing home or other long-term care facility./Think
back to the first/second/last/ time [in the last two years/since [PREV WAVE
FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]], that [she/he]
was a patient in a nursing home or other long-term care facility./Think about
[her/his] last stay at the nursing home or other long-term care facility.]
Was [FIRST NAME] eligible for (Medicaid/State name for Medicaid) at the time
[her/his] [first/second/last] nursing home stay started?
.................................................................................
12 1. YES
1 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1297 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF N127_ = NO;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN128_3 ELIGIBLE FOR MEDICAID DURNG NH STAY- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N128_
Did [she/he] become eligible for (Medicaid/State name for Medicaid) during that
nursing home stay?
.................................................................................
1. YES
1 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1309 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N129_ := ALLOTHS:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
*NOT(ELSE)*(IF piN115_TimeOverNH > 1);
*Assign N129_ := RHADMORETHAN1STAYINNHOMESINCELA:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF piN115_TimeOverNH > 1;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN129_3 BRNCHPNT-MORE THAN 1 NH STAY/ALL OTH-3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N129_
.................................................................................
13 1. R HAD MORE THAN 1 STAY IN NURSING HOME SINCE LAST WAVE
2. ALL OTHERS
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1297 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF piGovCoverN005_ = YES;
IF (((N127_ = YES) OR (N128_ = YES)) AND (((piN115_TimeOverNH <= 3) AND
(piLPCNTR = piN115_TimeOverNH)) OR (((piN115_TimeOverNH > 3) AND
piN115_TimeOverNH <> NONRESPONSE) AND (piLPCNTR = 3)))) AND
((PISecARelationsA028_RInNHome = NO) AND (PISecAContinuInterviewA124_PlaceDied
<> INNURSINGHOME));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN130_3 LOSE ELIGIBILITY-LAST NH STAY- 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N130_
Did [she/he] lose [her/his] eligibility for (Medicaid/State name for Medicaid)
when [she/he] was discharged from [her/his] (last) nursing home stay?
.................................................................................
1. YES
3 5. NO
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1307 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_TimeOverNH) AND (piLPCNTR <> 3))) OR
((((piLPCNTR = piN115_TimeOverNH) OR (piLPCNTR = 3)) AND
(SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME)) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN131_3 WHERE R LIVE AFTER NURSING HOME STAY -3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N131_LiveAftNH1
Where did [she/he] live after leaving the nursing home or health care facility?
(Did [she/he] live alone,[with you only,/with [her/his][husband/wife/partner]
only,] with one of [her/his] children and his or her own family, with other
relatives, in a retirement center, or what?)
.................................................................................
1 1. R LIVED BY HIM/HER SELF, ALONE
6 2. R LIVED WITH SPOUSE/PARTNER ONLY
4 3. R LIVED WITH CHILD AND CHILD'S FAMILY
4. R LIVED WITH OTHER RELATIVE(S)
5. R LIVED IN RETIREMENT CENTER
6 6. ANOTHER NURSING HOME, HOSPITAL,ASSISTED LIVING, REHAB CENTER
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1293 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N133_WhiChldNH1 := DONTKNOW:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_TimeOverNH) AND (piLPCNTR <> 3))) OR
((((piLPCNTR = piN115_TimeOverNH) OR (piLPCNTR = 3)) AND
(SecA.Relations.A167_A028_RInNHome <> YESNURSINGHOME)) AND
(PISecAContinuInterviewA124_PlaceDied <> INNURSINGHOME));
IF N131_LiveAftNH1 = RLIVEDWITHCHILDCHILDSFAM;
*NOT(ELSE)*(IF N255_N133_WhiChldNH1_A <> NONRESPONSE);
IF N255_N133_WhiChldNH1_A = DONTKNOW;
*Assign N133_WhiChldNH1 := REFUSAL:
IF ((N114_OverniteNH = YES) OR (SecA.ContinuInterview.A124_PlaceDied =
INNURSINGHOME)) OR (SecA.Relations.A167_A028_RInNHome = YESNURSINGHOME);
IF piLPCNTR <= piN115_TimeOverNH;
IF ((((piN115_TimeOverNH > 3) AND piN115_TimeOverNH <> NONRESPONSE) AND
(piLPCNTR < 3)) OR ((piLPCNTR < piN115_Tim
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN133_3 LIVE WITH WHICH CHILD AFTER NH STAY -3
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
Ref: SecN.NHomeStay.MedicaidNHomeStay[3].N133_WhiChldNH1
(Which child was that?)
If grandchild: (which of [her/his] children is the parent of that grandchild?)
.................................................................................
4 041-990. Other Person Number
992. DECEASED CHILD
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1306 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF PISecAContinuInterviewA124_PlaceDied = INHOSPICE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN315 HOSPICE- DAYS
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.Hospice.N315_
[Earlier you told me that [Respondent's First Name]] died while in a hospice.]
How long had [she/he] been a patient in that hospice before [her/his] death?
# Days:
Or
# Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
90 1 40 9.14 9.06 1218
-----------------------------------------------------------------
2 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
==========================================================================================
ASK:
IF PISecAContinuInterviewA124_PlaceDied = INHOSPICE;
IF N315_ = EMPTY OR (N315_ = DONTKNOW);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN316 HOSPICE- NUMBER MONTHS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.Hospice.N316_
[Earlier you told me that [Respondent's First Name]] died while in a hospice.]
How long had [she/he] been a patient in that hospice before [her/his] death?
# Days:
Or
# Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
10 1 12 4.50 3.84 1297
-----------------------------------------------------------------
3 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
UN320 SINCE LAST IW- HOSPICE PATIENT
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.Hospice.N320_
[In addition to that hospice stay, [in the last two years/since [PREV WAVE FIRST
R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]]/[In the last two
years/Since [PREV WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW YEAR]/[Prev Wave
Iw Yr]]] , had [she/he] been a patient overnight in a hospice?
.................................................................................
56 1. YES
1245 5. NO
5 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
3 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (PISecAContinuInterviewA124_PlaceDied = INHOSPICE) OR (N320_ = YES);
IF N320_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN321 HOSPICE PATIENT # TIMES
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.Hospice.N321_
[Including [her/his] final stay, how/How] many different times was [she/he] a
patient in a hospice [[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R
IW YEAR]/[Prev Wave Iw Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/in the last two years before her/his death]]?
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
55 1 15 1.71 2.11 1254
-----------------------------------------------------------------
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
==========================================================================================
ASK:
IF (PISecAContinuInterviewA124_PlaceDied = INHOSPICE) OR (N320_ = YES);
IF N320_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN322 SINCE LAST IW- HOSPICE # NIGHTS
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.Hospice.N322_
[Altogether, how/How] many nights was [she/he] a patient in a hospice [[since
[PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]]?
IWER: USE 996 FOR CONTINUOUS SINCE ENTERED OR [[SINCE [PREV WAVE FIRST R IW
MONTH], [PREV WAVE FIRST R IW YEAR]/[PREV WAVE IW YR]/SINCE [PREV WAVE FIRST R
IW YEAR]/[PREV WAVE IW YR]/IN THE LAST TWO YEARS BEFORE HER/HIS DEATH]]
Nights:
Or
Months:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
49 0 60 11.10 11.22 1259
-----------------------------------------------------------------
2 998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
==========================================================================================
ASK:
IF (PISecAContinuInterviewA124_PlaceDied = INHOSPICE) OR (N320_ = YES);
IF N320_ = YES;
IF N322_ = EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN323 SINCE LAST IW- HOSPICE # MONTHS
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.Hospice.N323_
[Altogether, how/How] How many nights was [she/he] a patient in a hospice
[[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]]?
IWER: USE 996 FOR CONTINUOUS SINCE ENTERED OR [[SINCE [PREV WAVE FIRST R IW
MONTH], [PREV WAVE FIRST R IW YEAR]/[PREV WAVE IW YR]/SINCE [PREV WAVE FIRST R
IW YEAR]/[PREV WAVE IW YR]/IN THE LAST TWO YEARS BEFORE HER/HIS DEATH]]
Nights:
Or
Months:
.................................................................................
4 2-6. Actual Value
1 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1305 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (PISecAContinuInterviewA124_PlaceDied = INHOSPICE) OR (N320_ = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN324 HOSPICE STAY COV BY INSURANCE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.Hospice.N324_
Were the costs for [her/his] hospice stay(s) completely covered by health
insurance, mostly covered, only partially covered, or not covered at all by
insurance?
.................................................................................
117 1. COMPLETELY COVERED
10 2. MOSTLY COVERED
4 3. PARTIALLY COVERED
10 5. NOT COVERED AT ALL
1 7. [VOL] COSTS NOT SETTLED YET
7 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1161 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (PISecAContinuInterviewA124_PlaceDied = INHOSPICE) OR (N320_ = YES);
IF N324_ <> COMPLETELYCOVRD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN328 OOP COSTS- HOSPICE- AMT
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.Hospice.N328_
About how much did [she/he] pay out-of-pocket for hospice bills [[since [PREV
WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/since
[PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years before
her/his death]]?
IWER: DO NOT PROBE DK/RF
IWER: INCLUDE ANY AMOUNTS PAID BY OTHERS.
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
15 0 18000 3850.33 6106.46 1278
-----------------------------------------------------------------
17 9999998. DK (Don't Know); NA (Not Ascertained)
9999999. RF (Refused)
==========================================================================================
*Assign N329_ := EMPTY:
IF (PISecAContinuInterviewA124_PlaceDied = INHOSPICE) OR (N320_ = YES);
IF N324_ <> COMPLETELYCOVRD;
IF N328_ <> EMPTY AND N328_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN329 OOP COSTS- HOSPICE- MIN
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.Hospice.N329_
N329 - N331 Unfolding Sequence
Question text: Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $500, $5,000, $10,000, $20,000, $50,000
RANDOM ENTRY POINTS: $5,000, $10,000, $20,000
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X511
.................................................................................
10 0. Value of Breakpoint
3 501. Value of Breakpoint
3 10001. Value of Breakpoint
1 50001. Value of Breakpoint
1293 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N330_ := EMPTY:
IF (PISecAContinuInterviewA124_PlaceDied = INHOSPICE) OR (N320_ = YES);
IF N324_ <> COMPLETELYCOVRD;
IF N328_ <> EMPTY AND N328_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN330 OOP COSTS- HOSPICE- MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.Hospice.N330_
.................................................................................
2 499. Value of Breakpoint
3 4999. Value of Breakpoint
1 19999. Value of Breakpoint
11 99999996. Greater than Maximum Breakpoint
1293 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N331_ := EMPTY:
IF (PISecAContinuInterviewA124_PlaceDied = INHOSPICE) OR (N320_ = YES);
IF N324_ <> COMPLETELYCOVRD;
IF N328_ <> EMPTY AND N328_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN331 OOP COSTS- HOSPICE- RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.Hospice.N331_
.................................................................................
10 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1300 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN147 # TIMES SEEN DR- PREV IW/2 YRS
Section: N Level: Respondent Type: Numeric Width: 3 Decimals: 0
Ref: SecN.DocVisit.N147_TimeSeeDoc
[Aside from any hospital stays, how/Aside from any outpatient surgery, how/Aside
from any hospital stays and outpatient surgery, how/How] many times did [she/he]
see or talk to a medical doctor about [her/his] health, including emergency room
or clinic visits [[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW
YEAR]/[Prev Wave Iw Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in
the last two years before her/his death]]?
IWER: USE ZERO FOR NONE
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
956 0 312 19.08 32.71 5
-----------------------------------------------------------------
345 998. DK (Don't Know); NA (Not Ascertained)
4 999. RF (Refused)
==========================================================================================
ASK:
IF N147_TimeSeeDoc = NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN148 NUMBER TIMES SEEN DOCTOR 20X
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.DocVisit.N148_TimeSeeDoc20
Did it amount to less than 20 times, more than 20 times, or what?
.................................................................................
97 1. LESS THAN 20 TIMES
45 3. ABOUT 20 TIMES
155 5. MORE THAN 20 TIMES
48 8. DK (Don't Know); NA (Not Ascertained)
4 9. RF (Refused)
961 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N147_TimeSeeDoc = NONRESPONSE;
IF N148_TimeSeeDoc20 <> ABT20TIMES;
IF N148_TimeSeeDoc20 <> MORETHAN20TIMES;
IF N148_TimeSeeDoc20 <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN149 NUMBER TIMES SEEN DOCTOR 5X
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.DocVisit.N149_TimeSeeDoc5
Did it amount to less than 5 times, more than 5 times, or what?
.................................................................................
12 1. LESS THAN 5 TIMES
6 3. ABOUT 5 TIMES
75 5. MORE THAN 5 TIMES
4 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1213 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N147_TimeSeeDoc = NONRESPONSE;
IF N148_TimeSeeDoc20 <> ABT20TIMES;
IF N148_TimeSeeDoc20 <> MORETHAN20TIMES;
IF (N149_TimeSeeDoc5 <> ABT5TIMES) AND (N149_TimeSeeDoc5 <> MORETHAN5TIMES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN150 HAS R SOUGHT DOC ADVICE IN PAST 2 YRS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.DocVisit.N150_DocAdvPast2Yrs
Do you think [she/he] saw a medical doctor about [her/his] health at least once
[[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]]?
.................................................................................
62 1. YES
1 5. NO
4 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
1242 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N147_TimeSeeDoc = NONRESPONSE;
IF N148_TimeSeeDoc20 <> ABT20TIMES;
IF N148_TimeSeeDoc20 = MORETHAN20TIMES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN151 R SEEK DOC ADVICE 50X
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.DocVisit.N151_SkDocAdv50
Did it amount to less than 50 times, more than 50 times, or what?
.................................................................................
50 1. LESS THAN 50 TIMES
18 3. ABOUT 50 TIMES
71 5. MORE THAN 50 TIMES
16 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1155 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N150_DocAdvPast2Yrs = YES) OR (((((N147_TimeSeeDoc <> 0) AND
(N147_TimeSeeDoc = RESPONSE)) OR (N148_TimeSeeDoc20 = ABT20TIMES)) OR
(N149_TimeSeeDoc5 = ABT5TIMES)) OR (N149_TimeSeeDoc5 = MORETHAN5TIMES))) OR
N151_SkDocAdv50 <> EMPTY;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN152 DOCTOR VISITS COVERED BY INSURANCE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.DocVisit.N152_VisitCovIns
Were the costs for [her/his] doctor or clinic visit(s) completely covered by
health insurance, mostly covered, only partially covered, or not covered at all
by insurance?
.................................................................................
681 1. COMPLETELY COVERED
383 2. MOSTLY COVERED
72 3. PARTIALLY COVERED
31 5. NOT COVERED AT ALL
9 7. [VOL] COSTS NOT SETTLED YET
56 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
78 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N150_DocAdvPast2Yrs = YES) OR (((((N147_TimeSeeDoc <> 0) AND
(N147_TimeSeeDoc = RESPONSE)) OR (N148_TimeSeeDoc20 = ABT20TIMES)) OR
(N149_TimeSeeDoc5 = ABT5TIMES)) OR (N149_TimeSeeDoc5 = MORETHAN5TIMES))) OR
N151_SkDocAdv50 <> EMPTY;
IF N152_VisitCovIns <> COMPLETELYCOVRD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN156 AMT PAY O-O-P FOR DOC VISITS
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.DocVisit.N156_AmtOOPVisit
About how much did [she/he] pay out-of-pocket for doctor or clinic visits
[[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]]?
IWER: DO NOT PROBE DK/RF
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
255 0 20000 800.62 1969.15 759
-----------------------------------------------------------------
292 9999998. DK (Don't Know); NA (Not Ascertained)
4 9999999. RF (Refused)
==========================================================================================
*Assign N157_ := EMPTY:
IF ((N150_DocAdvPast2Yrs = YES) OR (((((N147_TimeSeeDoc <> 0) AND
(N147_TimeSeeDoc = RESPONSE)) OR (N148_TimeSeeDoc20 = ABT20TIMES)) OR
(N149_TimeSeeDoc5 = ABT5TIMES)) OR (N149_TimeSeeDoc5 = MORETHAN5TIMES))) OR
N151_SkDocAdv50 <> EMPTY;
IF N152_VisitCovIns <> COMPLETELYCOVRD;
IF N156_AmtOOPVisit <> EMPTY AND N156_AmtOOPVisit <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN157 AMT PAY O-O-P FOR DOC VISITS - MIN
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.DocVisit.N157_
N157-N159 Unfolding Sequence
Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $500, $2,000, $5,000, $10,000, $20,000
RANDOM ENTRY POINTS: $2,000, $5,000, $10,000
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X515
.................................................................................
167 0. Value of Breakpoint
14 500. Value of Breakpoint
37 501. Value of Breakpoint
12 2000. Value of Breakpoint
17 2001. Value of Breakpoint
2 5000. Value of Breakpoint
38 5001. Value of Breakpoint
3 10001. Value of Breakpoint
1 20000. Value of Breakpoint
3 20001. Value of Breakpoint
1016 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N158_ := EMPTY:
IF ((N150_DocAdvPast2Yrs = YES) OR (((((N147_TimeSeeDoc <> 0) AND
(N147_TimeSeeDoc = RESPONSE)) OR (N148_TimeSeeDoc20 = ABT20TIMES)) OR
(N149_TimeSeeDoc5 = ABT5TIMES)) OR (N149_TimeSeeDoc5 = MORETHAN5TIMES))) OR
N151_SkDocAdv50 <> EMPTY;
IF N152_VisitCovIns <> COMPLETELYCOVRD;
IF N156_AmtOOPVisit <> EMPTY AND N156_AmtOOPVisit <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN158 AMT PAY O-O-P FOR DOC VISITS - MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.DocVisit.N158_
.................................................................................
62 499. Value of Breakpoint
14 500. Value of Breakpoint
45 1999. Value of Breakpoint
12 2000. Value of Breakpoint
25 4999. Value of Breakpoint
2 5000. Value of Breakpoint
9 9999. Value of Breakpoint
3 19999. Value of Breakpoint
1 20000. Value of Breakpoint
121 99999996. Greater than Maximum Breakpoint
1016 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N159_ := EMPTY:
IF ((N150_DocAdvPast2Yrs = YES) OR (((((N147_TimeSeeDoc <> 0) AND
(N147_TimeSeeDoc = RESPONSE)) OR (N148_TimeSeeDoc20 = ABT20TIMES)) OR
(N149_TimeSeeDoc5 = ABT5TIMES)) OR (N149_TimeSeeDoc5 = MORETHAN5TIMES))) OR
N151_SkDocAdv50 <> EMPTY;
IF N152_VisitCovIns <> COMPLETELYCOVRD;
IF N156_AmtOOPVisit <> EMPTY AND N156_AmtOOPVisit <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN159 AMT PAY O-O-P FOR DOC VISITS - RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.DocVisit.N159_
.................................................................................
2 97. Data not available
133 98. DK (Don't Know); NA (Not Ascertained)
3 99. RF (Refused)
1172 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N175_TkMedsReg := MEDICATIONSKNOWN:
IF ((((((piSecCBloodpressureC006_HBPMeds = YES) OR
(piSecCDiabetesC011_DiabetesMeds = YES)) OR (piSecCDiabetesC012_DiabetesInsulin
= YES)) OR (piSecCHeartAttackC046_AnginaMeds = YES)) OR
(piSecCHeartAttackC050_HeartFailMeds = YES)) OR (piSecCStrokeC060_StrokeMeds =
YES)) OR (piSecCPsychiatricC068_PsychMeds = YES);
ASK:
*NOT(ELSE)*(IF ((((((piSecCBloodpressureC006_HBPMeds = YES) OR
(piSecCDiabetesC011_DiabetesMeds = YES)) OR (piSecCDiabetesC012_DiabetesInsulin
= YES)) OR (piSecCHeartAttackC046_AnginaMeds = YES)) OR
(piSecCHeartAttackC050_HeartFailMeds = YES)) OR (piSecCStrokeC060_StrokeMeds =
YES)) OR (piSecCPsychiatricC068_PsychMeds = YES));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN175 TAKE PRESCRIPTION DRUGS REGULARLY
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PrescpDrug.N175_TkMedsReg
Was [she/he] regularly taking any prescription medications before [her/his]
death?
.................................................................................
1192 1. YES
95 5. NO
7. MEDICATIONS KNOWN
18 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
4 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N175_TkMedsReg <> NO) AND N175_TkMedsReg <> NONRESPONSE) AND ((((N366_ <>
USEWENTUP) AND (N366_ <> USEWENTDOWN)) AND (N367_ <> COSTWENTUP)) AND (N367_ <>
COSTWENTDOWN));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN176 DRUG COSTS COVERED BY INSURANCE
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.PrescpDrug.N176_MedsCovIns
[Earlier you said [she/he] was taking prescription medications.]
Were the costs of [her/his] prescription medications completely covered by
health insurance, mostly covered, only partially covered, or not covered at all
by insurance?
.................................................................................
349 1. COMPLETELY COVERED
406 2. MOSTLY COVERED
201 3. PARTIALLY COVERED
183 5. NOT COVERED AT ALL
2 7. [VOL] COSTS NOT SETTLED YET
51 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
118 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((N175_TkMedsReg <> NO) AND N175_TkMedsReg <> NONRESPONSE) AND ((((N366_ <>
USEWENTUP) AND (N366_ <> USEWENTDOWN)) AND (N367_ <> COSTWENTUP)) AND (N367_ <>
COSTWENTDOWN));
IF N176_MedsCovIns <> COMPLETELYCOVRD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN180 AMT PAY O-O-P RX DRUGS PER MONTH
Section: N Level: Respondent Type: Numeric Width: 5 Decimals: 0
Ref: SecN.PrescpDrug.N180_AmtOOPMeds
On average, about how much did [she/he] pay out-of-pocket per month for these
prescriptions [[since [PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW
YEAR]/[Prev Wave Iw Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in
the last two years before her/his death]]?
IWER: DO NOT PROBE DK/RF
Amount per month:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
538 0 6000 206.76 386.29 467
-----------------------------------------------------------------
300 99998. DK (Don't Know); NA (Not Ascertained)
5 99999. RF (Refused)
==========================================================================================
*Assign N181_ := EMPTY:
IF ((N175_TkMedsReg <> NO) AND N175_TkMedsReg <> NONRESPONSE) AND ((((N366_ <>
USEWENTUP) AND (N366_ <> USEWENTDOWN)) AND (N367_ <> COSTWENTUP)) AND (N367_ <>
COSTWENTDOWN));
IF N176_MedsCovIns <> COMPLETELYCOVRD;
IF N180_AmtOOPMeds <> EMPTY AND N180_AmtOOPMeds <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN181 AMT PAY O-O-P RX DRUGS PER MONTH- MIN
Section: N Level: Respondent Type: Numeric Width: 5 Decimals: 0
Ref: SecN.PrescpDrug.N181_
N181-N183 Unfolding Sequence
Did it amount to less than $____ per month, more than $____ per month, or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $20, $40, $100, $200, $500
RANDOM ENTRY POINTS: $40, $100, $200
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X517
.................................................................................
102 0. Value of Breakpoint
4 20. Value of Breakpoint
7 21. Value of Breakpoint
16 40. Value of Breakpoint
36 41. Value of Breakpoint
24 100. Value of Breakpoint
68 101. Value of Breakpoint
14 200. Value of Breakpoint
23 201. Value of Breakpoint
4 500. Value of Breakpoint
7 501. Value of Breakpoint
1005 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N182_ := EMPTY:
IF ((N175_TkMedsReg <> NO) AND N175_TkMedsReg <> NONRESPONSE) AND ((((N366_ <>
USEWENTUP) AND (N366_ <> USEWENTDOWN)) AND (N367_ <> COSTWENTUP)) AND (N367_ <>
COSTWENTDOWN));
IF N176_MedsCovIns <> COMPLETELYCOVRD;
IF N180_AmtOOPMeds <> EMPTY AND N180_AmtOOPMeds <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN182 AMT PAY O-O-P RX DRUGS PER MONTH- MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.PrescpDrug.N182_
.................................................................................
7 19. Value of Breakpoint
4 20. Value of Breakpoint
11 39. Value of Breakpoint
16 40. Value of Breakpoint
39 99. Value of Breakpoint
24 100. Value of Breakpoint
30 199. Value of Breakpoint
14 200. Value of Breakpoint
19 499. Value of Breakpoint
4 500. Value of Breakpoint
137 99999996. Greater than Maximum Breakpoint
1005 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N183_ := EMPTY:
IF ((N175_TkMedsReg <> NO) AND N175_TkMedsReg <> NONRESPONSE) AND ((((N366_ <>
USEWENTUP) AND (N366_ <> USEWENTDOWN)) AND (N367_ <> COSTWENTUP)) AND (N367_ <>
COSTWENTDOWN));
IF N176_MedsCovIns <> COMPLETELYCOVRD;
IF N180_AmtOOPMeds <> EMPTY AND N180_AmtOOPMeds <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN183 AMT PAY O-O-P RX DRUGS PER MONTH- RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.PrescpDrug.N183_
.................................................................................
142 98. DK (Don't Know); NA (Not Ascertained)
3 99. RF (Refused)
1165 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piN116_NiteOverNH <> 996) OR ((piX008AInNHome_V <> INNURSINGHOME) AND
(piN116_NiteOverNH = 996));
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN189 USED HOME HEALTH SVC- PREV IW/2 YRS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.InHomeCare.N189_HomeHlthSvc
[In the last two years/Since [PREV WAVE FIRST R IW MO], [PREV WAVE FIRST R IW
YEAR]/[Prev Wave Iw Yr]] , did any medically-trained person come to [her/his]
home to help [her/him ]?
IWER: WE ONLY WANT TO INCLUDE HELP GIVEN TO R, NOT HELP FOR R WHEN R IS A
CAREGIVER FOR SOMEONE ELSE
Def: (Medically-trained persons include professional nurses,visiting nurse's
aides, physical or occupational therapists, chemotherapists, and respiratory
oxygen therapists.)
.................................................................................
542 1. YES
731 5. NO
19 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
17 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piN116_NiteOverNH <> 996) OR ((piX008AInNHome_V <> INNURSINGHOME) AND
(piN116_NiteOverNH = 996));
IF N189_HomeHlthSvc = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN190 HOME HEALTH SERVICE COST COVERED BY INS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.InHomeCare.N190_HHSvcCovIns
Were the costs of [her/his] home medical care completely covered by health
insurance, mostly covered, only partially covered, or not covered at all by
insurance?
.................................................................................
427 1. COMPLETELY COVERED
50 2. MOSTLY COVERED
15 3. PARTIALLY COVERED
26 5. NOT COVERED AT ALL
2 6. No charge (professional courtesy, friend or relative
provided services; part of a study, free clinic, pro bono)
1 7. [VOL] COSTS NOT SETTLED YET
20 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
768 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF (piN116_NiteOverNH <> 996) OR ((piX008AInNHome_V <> INNURSINGHOME) AND
(piN116_NiteOverNH = 996));
IF N189_HomeHlthSvc = YES;
IF N190_HHSvcCovIns <> COMPLETELYCOVRD;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN194 AMT PAY O-O-P HOME HEALTH SVC
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.InHomeCare.N194_AmtPayOOPHHS
About how much did [she/he] pay out-of-pocket for in-home medical care [[since
[PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]]?
IWER: DO NOT PROBE DK/RF
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
52 0 70000 4522.87 13447.26 1197
-----------------------------------------------------------------
60 999998. DK (Don't Know); NA (Not Ascertained)
1 999999. RF (Refused)
==========================================================================================
*Assign N195_ := EMPTY:
IF (piN116_NiteOverNH <> 996) OR ((piX008AInNHome_V <> INNURSINGHOME) AND
(piN116_NiteOverNH = 996));
IF N189_HomeHlthSvc = YES;
IF N190_HHSvcCovIns <> COMPLETELYCOVRD;
IF N194_AmtPayOOPHHS <> EMPTY AND N194_AmtPayOOPHHS <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN195 AMT PAY O-O-P HOME HEALTH SVC - MIN
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.InHomeCare.N195_
N195-N197 Unfolding Sequence
Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $500, $2,000, $5,000, $10,000, $20,000
RANDOM ENTRY POINTS: $2,000, $5,000, $10,000
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X518
.................................................................................
34 0. Value of Breakpoint
1 500. Value of Breakpoint
5 501. Value of Breakpoint
2 2000. Value of Breakpoint
3 2001. Value of Breakpoint
1 5000. Value of Breakpoint
12 5001. Value of Breakpoint
1 10001. Value of Breakpoint
1251 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N196_ := EMPTY:
IF (piN116_NiteOverNH <> 996) OR ((piX008AInNHome_V <> INNURSINGHOME) AND
(piN116_NiteOverNH = 996));
IF N189_HomeHlthSvc = YES;
IF N190_HHSvcCovIns <> COMPLETELYCOVRD;
IF N194_AmtPayOOPHHS <> EMPTY AND N194_AmtPayOOPHHS <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN196 AMT PAY O-O-P HOME HEALTH SVC - MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.InHomeCare.N196_
.................................................................................
10 499. Value of Breakpoint
1 500. Value of Breakpoint
6 1999. Value of Breakpoint
2 2000. Value of Breakpoint
3 4999. Value of Breakpoint
1 5000. Value of Breakpoint
1 9999. Value of Breakpoint
1 19999. Value of Breakpoint
34 99999996. Greater than Maximum Breakpoint
1251 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N197_ := EMPTY:
IF (piN116_NiteOverNH <> 996) OR ((piX008AInNHome_V <> INNURSINGHOME) AND
(piN116_NiteOverNH = 996));
IF N189_HomeHlthSvc = YES;
IF N190_HHSvcCovIns <> COMPLETELYCOVRD;
IF N194_AmtPayOOPHHS <> EMPTY AND N194_AmtPayOOPHHS <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN197 AMT PAY O-O-P HOME HEALTH SVC - RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.InHomeCare.N197_
.................................................................................
2 97. Data not available
35 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1273 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN202 USED OTHER HEALTH SVC- PREV IW/2 YRS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.OthHealthCare.N202_UseOthSvc
IWER: READ SLOWLY
[In the last two years/Since [PREV WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW
YEAR]/[Prev Wave Iw Yr]], did [she/he] use any special facility or service which
we haven't talked about, such as: an adult care center, a social worker, an
outpatient rehabilitation program, or transportation or meals for the elderly or
disabled?
.................................................................................
276 1. YES
1018 5. NO
11 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
4 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N202_UseOthSvc = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN203 OTHER HEALTH SVC PAID BY R/SP/P
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.OthHealthCare.N203_OthSvcCovIns
Did [she/he] [or/ or her/his] [you/husband/wife/partner] have to pay for any of
these services?
.................................................................................
69 1. YES
200 5. NO
7 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1034 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N202_UseOthSvc = YES;
IF N203_OthSvcCovIns = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN239 AMT PAY O-O-P OTHER HEALTH SERVICE
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.OthHealthCare.N239_OthSvcCost
Altogether, about how much did [she/he] have to pay?
IWER: DO NOT PROBE DK/RF
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
45 2 18000 951.60 2761.35 1241
-----------------------------------------------------------------
24 9999998. DK (Don't Know); NA (Not Ascertained)
9999999. RF (Refused)
==========================================================================================
*Assign N246_ := EMPTY:
IF N202_UseOthSvc = YES;
IF N203_OthSvcCovIns = YES;
IF N239_OthSvcCost <> EMPTY AND N239_OthSvcCost <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN246 AMT PAY O-O-P OTHER HEALTH SERVICE- MIN
Section: N Level: Respondent Type: Numeric Width: 7 Decimals: 0
Ref: SecN.OthHealthCare.N246_
N246-N248 Unfolding Sequence
Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $500, $1,000, $5,000, $10,000, $20,000
RANDOM ENTRY POINTS: $1,000, $5,000, $10,000
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X519
.................................................................................
15 0. Value of Breakpoint
1 500. Value of Breakpoint
1 501. Value of Breakpoint
1 1001. Value of Breakpoint
3 5001. Value of Breakpoint
1 10001. Value of Breakpoint
1 20001. Value of Breakpoint
1287 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N247_ := EMPTY:
IF N202_UseOthSvc = YES;
IF N203_OthSvcCovIns = YES;
IF N239_OthSvcCost <> EMPTY AND N239_OthSvcCost <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN247 AMT PAY O-O-P OTHER HEALTH SERVICE- MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.OthHealthCare.N247_
.................................................................................
12 499. Value of Breakpoint
1 500. Value of Breakpoint
1 999. Value of Breakpoint
1 4999. Value of Breakpoint
1 9999. Value of Breakpoint
1 19999. Value of Breakpoint
6 99999996. Greater than Maximum Breakpoint
1287 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N248_ := EMPTY:
IF N202_UseOthSvc = YES;
IF N203_OthSvcCovIns = YES;
IF N239_OthSvcCost <> EMPTY AND N239_OthSvcCost <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN248 AMT PAY O-O-P OTHER HEALTH SVC- RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.OthHealthCare.N248_
.................................................................................
1 97. Data not available
5 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1304 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN332 OTHER OOP MEDICAL EXPENSES
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.OthHealthCare.N332_
Aside from the medical expenses we already mentioned, did [FIRST NAME] have any
other out-of-pocket medical expenses, that is, expenses not covered by
insurance, such as medications, special food, equipment such as a special bed or
chair, visits by doctors or other health professionals, or other costs?
.................................................................................
282 1. YES
988 5. NO
33 8. DK (Don't Know); NA (Not Ascertained)
3 9. RF (Refused)
4 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N332_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN333 OTHER OOP COSTS- AMT
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.OthHealthCare.N333_
About how much did [she/he] pay out-of-pocket for these expenses [[since [PREV
WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/since
[PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years before
her/his death]]?
IWER: DO NOT PROBE DK/RF
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
187 0 45000 1705.21 4800.98 1028
-----------------------------------------------------------------
94 999998. DK (Don't Know); NA (Not Ascertained)
1 999999. RF (Refused)
==========================================================================================
*Assign N334_ := EMPTY:
IF N332_ = YES;
IF N333_ <> EMPTY AND N333_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN334 OTHER OOP COSTS- MIN
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.OthHealthCare.N334_
N334-N336 Unfolding Sequence
Question text: Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $500, $1,000, $5,000, $10,000, $20,000
RANDOM ENTRY POINTS: $1,000, $5,000, $10,000
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X520
.................................................................................
41 0. Value of Breakpoint
9 500. Value of Breakpoint
8 501. Value of Breakpoint
7 1000. Value of Breakpoint
14 1001. Value of Breakpoint
5 5000. Value of Breakpoint
6 5001. Value of Breakpoint
1 10001. Value of Breakpoint
2 20001. Value of Breakpoint
1217 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N335_ := EMPTY:
IF N332_ = YES;
IF N333_ <> EMPTY AND N333_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN335 OTHER OOP COSTS- MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.OthHealthCare.N335_
.................................................................................
23 499. Value of Breakpoint
9 500. Value of Breakpoint
9 999. Value of Breakpoint
7 1000. Value of Breakpoint
17 4999. Value of Breakpoint
5 5000. Value of Breakpoint
4 9999. Value of Breakpoint
1 19999. Value of Breakpoint
18 99999996. Greater than Maximum Breakpoint
1217 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N336_ := EMPTY:
IF N332_ = YES;
IF N333_ <> EMPTY AND N333_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN336 OTHER OOP COSTS- RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.OthHealthCare.N336_
.................................................................................
2 97. Data not available
21 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
1286 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N204_AssgnHospCost := 0:
*NOT(ELSE)*(IF HospitalStay.N106_AmtOOPHospCost = RESPONSE);
*NOT(ELSE)*(IF ((HospitalStay.N106_AmtOOPHospCost = DONTKNOW) OR
(HospitalStay.N106_AmtOOPHospCost = REFUSAL)) AND (HospitalStay.N107_ =
RESPONSE));
*Assign N204_AssgnHospCost := HospitalStay.N106_AmtOOPHospCost:
IF HospitalStay.N106_AmtOOPHospCost = RESPONSE;
*Assign N204_AssgnHospCost := HospitalStay.N107_:
*NOT(ELSE)*(IF HospitalStay.N106_AmtOOPHospCost = RESPONSE);
IF ((HospitalStay.N106_AmtOOPHospCost = DONTKNOW) OR
(HospitalStay.N106_AmtOOPHospCost = REFUSAL)) AND (HospitalStay.N107_ =
RESPONSE);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN204 ASSIGN HOSPITAL COSTS
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N204_AssgnHospCost
User Note: N106 and N107 are used to calculate UN204.
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1310 0 140000 1019.23 5172.26 0
-----------------------------------------------------------------
==========================================================================================
*Assign N205_AssgnNHCost := 0:
*NOT(ELSE)*(IF NHomeStay.N119_AmtPayNHHosp = RESPONSE);
*NOT(ELSE)*(IF ((NHomeStay.N119_AmtPayNHHosp = DONTKNOW) OR
(NHomeStay.N119_AmtPayNHHosp = REFUSAL)) AND (NHomeStay.N120_ = RESPONSE));
*Assign N205_AssgnNHCost := NHomeStay.N119_AmtPayNHHosp:
IF NHomeStay.N119_AmtPayNHHosp = RESPONSE;
*Assign N205_AssgnNHCost := NHomeStay.N120_:
*NOT(ELSE)*(IF NHomeStay.N119_AmtPayNHHosp = RESPONSE);
IF ((NHomeStay.N119_AmtPayNHHosp = DONTKNOW) OR (NHomeStay.N119_AmtPayNHHosp =
REFUSAL)) AND (NHomeStay.N120_ = RESPONSE);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN205 ASSIGN NURSING HOME COSTS
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N205_AssgnNHCost
User Note: N119 and N120 are used to calculate UN205.
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1310 0 328000 2967.83 14694.05 0
-----------------------------------------------------------------
==========================================================================================
*Assign N207_AssgnDocVstCost := 0:
*NOT(ELSE)*(IF DocVisit.N156_AmtOOPVisit = RESPONSE);
*NOT(ELSE)*(IF ((DocVisit.N156_AmtOOPVisit = DONTKNOW) OR
(DocVisit.N156_AmtOOPVisit = REFUSAL)) AND (DocVisit.N157_ = RESPONSE));
*Assign N207_AssgnDocVstCost := DocVisit.N156_AmtOOPVisit:
IF DocVisit.N156_AmtOOPVisit = RESPONSE;
*Assign N207_AssgnDocVstCost := DocVisit.N157_:
*NOT(ELSE)*(IF DocVisit.N156_AmtOOPVisit = RESPONSE);
IF ((DocVisit.N156_AmtOOPVisit = DONTKNOW) OR (DocVisit.N156_AmtOOPVisit =
REFUSAL)) AND (DocVisit.N157_ = RESPONSE);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN207 ASSIGN DOCTOR VISIT COSTS
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N207_AssgnDocVstCost
User Note: N156 and N157 are used to calculate UN207.
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1310 0 20001 456.30 1727.19 0
-----------------------------------------------------------------
==========================================================================================
*Assign N209_AssgnPresCost := 0:
*NOT(ELSE)*(IF PrescpDrug.N180_AmtOOPMeds = RESPONSE);
*NOT(ELSE)*(IF ((PrescpDrug.N180_AmtOOPMeds = DONTKNOW) OR
(PrescpDrug.N180_AmtOOPMeds = REFUSAL)) AND (PrescpDrug.N181_ = RESPONSE));
*Assign N209_AssgnPresCost := PrescpDrug.N180_AmtOOPMeds:
IF PrescpDrug.N180_AmtOOPMeds = RESPONSE;
*Assign N209_AssgnPresCost := PrescpDrug.N181_:
*NOT(ELSE)*(IF PrescpDrug.N180_AmtOOPMeds = RESPONSE);
IF ((PrescpDrug.N180_AmtOOPMeds = DONTKNOW) OR (PrescpDrug.N180_AmtOOPMeds =
REFUSAL)) AND (PrescpDrug.N181_ = RESPONSE);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN209 ASSIGN PRESCRIPTION COSTS
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N209_AssgnPresCost
User Note: N180 and N181 are used to calculate UN209.
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1310 0 6000 103.65 268.44 0
-----------------------------------------------------------------
==========================================================================================
*Assign N210_AssgnHomeHCCost := 0:
*NOT(ELSE)*(IF InHomeCare.N194_AmtPayOOPHHS = RESPONSE);
*NOT(ELSE)*(IF ((InHomeCare.N194_AmtPayOOPHHS = DONTKNOW) OR
(InHomeCare.N194_AmtPayOOPHHS = REFUSAL)) AND (InHomeCare.N195_ = RESPONSE));
*Assign N210_AssgnHomeHCCost := InHomeCare.N194_AmtPayOOPHHS:
IF InHomeCare.N194_AmtPayOOPHHS = RESPONSE;
*Assign N210_AssgnHomeHCCost := InHomeCare.N195_:
*NOT(ELSE)*(IF InHomeCare.N194_AmtPayOOPHHS = RESPONSE);
IF ((InHomeCare.N194_AmtPayOOPHHS = DONTKNOW) OR (InHomeCare.N194_AmtPayOOPHHS =
REFUSAL)) AND (InHomeCare.N195_ = RESPONSE);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN210 ASSIGN IN-HOME HEALTH CARE COSTS
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N210_AssgnHomeHCCost
User Note: N194 and N195 are used to calculate UN210.
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1310 0 70000 246.73 2852.75 0
-----------------------------------------------------------------
==========================================================================================
UN211 TOTAL O-O-P FOR MAJOR MEDICAL COSTS
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N211_TotMajMedExp
User Note: UN211 = N204 + N205 + N207+ N209 + N210
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
1310 0 328100 4793.74 16911.27 0
-----------------------------------------------------------------
==========================================================================================
UN212 HELP PAY HEALTH CARE COSTS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HowPayMedBill.N212_HelpPayHCCost
Besides any costs covered by insurance, did anyone help [her/him ] [ and / and
her/his ] [you/husband/wife/partner] pay for [her/his] health care costs [[since
[PREV WAVE FIRST R IW Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw
Yr]/since [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/in the last two years
before her/his death]], or help [her/him ] pay the cost of health insurance or
for long-term care insurance?
.................................................................................
84 1. YES
1203 5. NO
18 8. DK (Don't Know); NA (Not Ascertained)
1 9. RF (Refused)
4 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N212_HelpPayHCCost = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN213 WHO HELP PAY HEALTH CARE COSTS
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HowPayMedBill.N213_WhoHelpPayHCCost
Was that a [child or other] relative of [[[Respondent's First Name]]`s /hers/his
]] [ and / and her/his you/husband/wife/partner`s/ / and yours], or was that
someone else?
.................................................................................
65 1. CHILD/CHILD-IN-LAW/GRANDCHILD
10 2. OTHER RELATIVE
9 3. SOMEONE ELSE
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1226 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N214AWhiChldPayHC[1] := DONTKNOW:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
IF N254_N214MWhiChldPayHC = DONTKNOW;
*Assign N214AWhiChldPayHC[1] := REFUSAL:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC = DONTKNOW);
IF N254_N214MWhiChldPayHC = REFUSAL;
*Assign N214AWhiChldPayHC[cnt] := aArrayInteger[N254_N214MWhiChldPayHC[cnt.ORD]:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
IF N254_N214MWhiChldPayHC <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN214M1 WHICH CHILD PAY HEALTH CARE COSTS-1
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
Ref: SecN.HowPayMedBill.N214AWhiChldPayHC[1]
(Which child was that?)
IWER: CHOOSE ALL THAT APPLY
IWER: ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE: Which child helped the most?
If grandchild: (Which of [her/his] children is the parent of that grandchild?)
.................................................................................
52 041-990. Other Person Number
992. DECEASED CHILD
13 993. ALL CHILDREN EQUALLY
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1245 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N214AWhiChldPayHC[1] := DONTKNOW:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
IF N254_N214MWhiChldPayHC = DONTKNOW;
*Assign N214AWhiChldPayHC[1] := REFUSAL:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC = DONTKNOW);
IF N254_N214MWhiChldPayHC = REFUSAL;
*Assign N214AWhiChldPayHC[cnt] := aArrayInteger[N254_N214MWhiChldPayHC[cnt.ORD]:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
IF N254_N214MWhiChldPayHC <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN214M2 WHICH CHILD PAY HEALTH CARE COSTS-2
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
Ref: SecN.HowPayMedBill.N214AWhiChldPayHC[2]
(Which child was that?)
IWER: CHOOSE ALL THAT APPLY
IWER: ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE:: Which child helped the most?
If grandchild: (Which of [her/his] children is the parent of that grandchild?)
.................................................................................
9 041-990. Other Person Number
992. DECEASED CHILD
993. ALL CHILDREN EQUALLY
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1301 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N214AWhiChldPayHC[1] := DONTKNOW:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
IF N254_N214MWhiChldPayHC = DONTKNOW;
*Assign N214AWhiChldPayHC[1] := REFUSAL:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC = DONTKNOW);
IF N254_N214MWhiChldPayHC = REFUSAL;
*Assign N214AWhiChldPayHC[cnt] := aArrayInteger[N254_N214MWhiChldPayHC[cnt.ORD]:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
IF N254_N214MWhiChldPayHC <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN214M3 WHICH CHILD PAY HEALTH CARE COSTS-3
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
Ref: SecN.HowPayMedBill.N214AWhiChldPayHC[3]
(Which child was that?)
IWER: CHOOSE ALL THAT APPLY
IWER: ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE: Which child helped the most?
If grandchild: (Which of [her/his] children is the parent of that grandchild?)
.................................................................................
5 041-990. Other Person Number
992. DECEASED CHILD
993. ALL CHILDREN EQUALLY
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1305 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N214AWhiChldPayHC[1] := DONTKNOW:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
IF N254_N214MWhiChldPayHC = DONTKNOW;
*Assign N214AWhiChldPayHC[1] := REFUSAL:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC = DONTKNOW);
IF N254_N214MWhiChldPayHC = REFUSAL;
*Assign N214AWhiChldPayHC[cnt] := aArrayInteger[N254_N214MWhiChldPayHC[cnt.ORD]:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
IF N254_N214MWhiChldPayHC <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN214M4 WHICH CHILD PAY HEALTH CARE COSTS-4
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
Ref: SecN.HowPayMedBill.N214AWhiChldPayHC[4]
(Which child was that?)
IWER: CHOOSE ALL THAT APPLY
IWER: ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE: Which child helped the most?
If grandchild: (Which of [her/his] children is the parent of that grandchild?)
.................................................................................
3 041-990. Other Person Number
992. DECEASED CHILD
993. ALL CHILDREN EQUALLY
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1307 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N214AWhiChldPayHC[1] := DONTKNOW:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
IF N254_N214MWhiChldPayHC = DONTKNOW;
*Assign N214AWhiChldPayHC[1] := REFUSAL:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC <> NONRESPONSE);
*NOT(ELSE)*(IF N254_N214MWhiChldPayHC = DONTKNOW);
IF N254_N214MWhiChldPayHC = REFUSAL;
*Assign N214AWhiChldPayHC[cnt] := aArrayInteger[N254_N214MWhiChldPayHC[cnt.ORD]:
IF N212_HelpPayHCCost = YES;
IF N213_WhoHelpPayHCCost = CHILDCHILDLAWGRANDCHILD;
IF cnt <= N254_N214MWhiChldPayHC.CARDINAL;
IF N254_N214MWhiChldPayHC <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN214M5 WHICH CHILD PAY HEALTH CARE COSTS-5
Section: N Level: Respondent Type: Character Width: 3 Decimals: 0
Ref: SecN.HowPayMedBill.N214AWhiChldPayHC[5]
(Which child was that?)
IWER: CHOOSE ALL THAT APPLY
IWER: ACCEPT MORE THAN 1 CHILD ONLY AFTER PROBE: Which child helped the most?
If grandchild: (Which of [her/his] children is the parent of that grandchild?)
.................................................................................
041-990. Other Person Number
992. DECEASED CHILD
993. ALL CHILDREN EQUALLY
998. DK (Don't Know); NA (Not Ascertained)
999. RF (Refused)
1310 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N212_HelpPayHCCost = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN215 AMT OF OTHER HELP
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.HowPayMedBill.N215_AmtOthHelp
Altogether, about how much money did that help amount to?
IWER: DO NOT PROBE DK/RF
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
52 25 60000 6315.98 11801.67 1226
-----------------------------------------------------------------
31 999998. DK (Don't Know); NA (Not Ascertained)
1 999999. RF (Refused)
==========================================================================================
*Assign N216_ := EMPTY:
IF N212_HelpPayHCCost = YES;
IF N215_AmtOthHelp <> EMPTY AND N215_AmtOthHelp <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN216 AMT OF OTHER HELP - MIN
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.HowPayMedBill.N216_
N216-N218 Unfolding Sequence
Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 2Up1Down, 1Up2Down
BREAKPOINTS: $500, $1,000, $3,000, $10,000
RANDOM ENTRY POINTS: $1,000, $3,000
ENTRY POINT ASSIGNMENT: 1 or {NOT 1} AT X503
.................................................................................
13 0. Value of Breakpoint
1 501. Value of Breakpoint
2 1000. Value of Breakpoint
4 1001. Value of Breakpoint
4 3000. Value of Breakpoint
8 3001. Value of Breakpoint
1278 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N217_ := EMPTY:
IF N212_HelpPayHCCost = YES;
IF N215_AmtOthHelp <> EMPTY AND N215_AmtOthHelp <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN217 AMT OF OTHER HELP - MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.HowPayMedBill.N217_
.................................................................................
3 499. Value of Breakpoint
1 999. Value of Breakpoint
2 1000. Value of Breakpoint
4 2999. Value of Breakpoint
4 3000. Value of Breakpoint
7 9999. Value of Breakpoint
11 99999996. Greater than Maximum Breakpoint
1278 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N218_ := EMPTY:
IF N212_HelpPayHCCost = YES;
IF N215_AmtOthHelp <> EMPTY AND N215_AmtOthHelp <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN218 AMT OF OTHER HELP - RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.HowPayMedBill.N218_
.................................................................................
10 98. DK (Don't Know); NA (Not Ascertained)
1 99. RF (Refused)
1299 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF piN211_TotMajMedExp >= 10000;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN219M1 HOW FINANCE LARGE MEDICAL EXPENSES - 1
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HowPayMedBill.N219_HowFinLgMedExp[1]
[You have just told me that [she/he] has had some rather large out-of pocket
medical expenditures.
Apart from what [she/he] received from others, how/You have just told me that
[she/he] has had some rather large out-of-pocket medical expenditures. How] did
[she/he] finance these -- did [she/he] pay directly from [her/his] savings or
earnings, did [she/he] take out a loan, has [she/he] not yet paid these bills,
or what?
IWER: CHOOSE ALL THAT APPLY
IWER: IF PAYMENTS ARE STILL BEING MADE, ENTER BOTH CODE 3 AND CODE 4.
.................................................................................
130 1. PAID USING SAVINGS/EARNINGS
2 2. TOOK OUT A LOAN
11 3. HAVE NOT YET PAID
4 4. MAKING PAYMENTS
5 5. Not paid by R (filed for bankruptcy, someone else [like a
relative] paid, doctor let the bills drop, etc)
5 6. Records Inaccurate, R did not have large out of pocket
expenses
7. OTHER (SPECIFY)
24 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1129 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF piN211_TotMajMedExp >= 10000;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN219M2 HOW FINANCE LARGE MEDICAL EXPENSES - 2
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HowPayMedBill.N219_HowFinLgMedExp[2]
[You have just told me that [she/he] has had some rather large out-of pocket
medical expenditures.
Apart from what [she/he] received from others, how/You have just told me that
[she/he] has had some rather large out-of-pocket medical expenditures. How] did
[she/he] finance these -- did [she/he] pay directly from [her/his] savings or
earnings, did [she/he] take out a loan, has [she/he] not yet paid these bills,
or what?
IWER: CHOOSE ALL THAT APPLY
IWER: IF PAYMENTS ARE STILL BEING MADE, ENTER BOTH CODE 3 AND CODE 4.
.................................................................................
1 1. PAID USING SAVINGS/EARNINGS
2 2. TOOK OUT A LOAN
3 3. HAVE NOT YET PAID
1 4. MAKING PAYMENTS
3 5. Not paid by R (filed for bankruptcy, someone else [like a
relative] played, doctor let the bills drop, etc)
6. Records Inaccurate, R did not have large out of pocket
expenses
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1300 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF piN211_TotMajMedExp >= 10000;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN219M3 HOW FINANCE LARGE MEDICAL EXPENSES - 3
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HowPayMedBill.N219_HowFinLgMedExp[3]
[You have just told me that [she/he] has had some rather large out-of pocket
medical expenditures.
Apart from what [she/he] received from others, how/You have just told me that
[she/he] has had some rather large out-of-pocket medical expenditures. How] did
[she/he] finance these -- did [she/he] pay directly from [her/his] savings or
earnings, did [she/he] take out a loan, has [she/he] not yet paid these bills,
or what?
IWER: CHOOSE ALL THAT APPLY
IWER: IF PAYMENTS ARE STILL BEING MADE, ENTER BOTH CODE 3 AND CODE 4.
.................................................................................
1. PAID USING SAVINGS/EARNINGS
2. TOOK OUT A LOAN
1 3. HAVE NOT YET PAID
1 4. MAKING PAYMENTS
5. Not paid by R (filed for bankruptcy, someone else [like a
relative] played, doctor let the bills drop, etc)
6. Records Inaccurate, R did not have large out of pocket
expenses
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1308 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF piN211_TotMajMedExp >= 10000;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN219M4 HOW FINANCE LARGE MEDICAL EXPENSES-4
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HowPayMedBill.N219_HowFinLgMedExp[4]
[You have just told me that [she/he] has had some rather large out-of pocket
medical expenditures.
Apart from what [she/he] received from others, how/You have just told me that
[she/he] has had some rather large out-of-pocket medical expenditures. How] did
[she/he] finance these -- did [she/he] pay directly from [her/his] savings or
earnings, did [she/he] take out a loan, has [she/he] not yet paid these bills,
or what?
IWER: CHOOSE ALL THAT APPLY
IWER: IF PAYMENTS ARE STILL BEING MADE, ENTER BOTH CODE 3 AND CODE 4.
.................................................................................
1. PAID USING SAVINGS/EARNINGS
2. TOOK OUT A LOAN
3. HAVE NOT YET PAID
4. MAKING PAYMENTS
1 5. Not paid by R (filed for bankruptcy, someone else [like a
relative] played, doctor let the bills drop, etc)
6. Records Inaccurate, R did not have large out of pocket
expenses
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1309 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF piN211_TotMajMedExp >= 10000;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN219M5 HOW FINANCE LARGE MEDICAL EXPENSES-5
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.HowPayMedBill.N219_HowFinLgMedExp[5]
[You have just told me that [she/he] has had some rather large out-of pocket
medical expenditures.
Apart from what [she/he] received from others, how/You have just told me that
[she/he] has had some rather large out-of-pocket medical expenditures. How] did
[she/he] finance these -- did [she/he] pay directly from [her/his] savings or
earnings, did [she/he] take out a loan, has [she/he] not yet paid these bills,
or what?
IWER: CHOOSE ALL THAT APPLY
IWER: IF PAYMENTS ARE STILL BEING MADE, ENTER BOTH CODE 3 AND CODE 4.
.................................................................................
1. PAID USING SAVINGS/EARNINGS
2. TOOK OUT A LOAN
3. HAVE NOT YET PAID
4. MAKING PAYMENTS
5. Not paid by R (filed for bankruptcy, someone else [like a
relative] played, doctor let the bills drop, etc)
6. Records Inaccurate, R did not have large out of pocket
expenses
7. OTHER (SPECIFY)
8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1310 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((SecA.StartInterview.A009_SelfPrxy = SLF) OR (ACTIVELANGUAGE = EXTENG)) OR
(ACTIVELANGUAGE = EXTSPN);
IF (piRvarsZ113_GaveMedcareNo_V <> YES) AND (piGovCoverN001_ = YES);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN226 MEDICARE NUMBER RECORDED
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.MediCareCaidNumber.N226_MedicareNumRec
We would like to understand how people's medical history affects their financial
status, and how use of health care may change as people age. To do that, we need
to obtain information about health care costs and diagnoses for statistical
purposes. The best place to get this information without taking up a lot more of
your time is in the Medicare files.
Could you give me [her/his] Medicare number for this purpose?
(Under the Privacy Act of 1974, providing [her/his] number is a voluntary
decision. Any remaining benefits under this program will not be affected in any
way by your decision.)
.................................................................................
53 1. NUMBER RECORDED
20 4. R REFUSED NUMBER
77 5. NUMBER NOT RECORDED (NOT REFUSED)
9 8. DK (Don't Know); NA (Not Ascertained)
9. RF (Refused)
1151 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF ((SecA.StartInterview.A009_SelfPrxy = SLF) OR (ACTIVELANGUAGE = EXTENG)) OR
(ACTIVELANGUAGE = EXTSPN);
IF (piGovCoverN006_ = YES) AND (N226_MedicareNumRec <> RREFUSEDNUMBER);
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN231 MEDICAID NUMBER RECORDED
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.MediCareCaidNumber.N231_MedicaidNumRec
(We would like to understand how people's medical history affects their
financial status, and how use of health care may change as people age. To do
that, we need to obtain information about health care costs and diagnoses for
statistical purposes. The best place to get this information without taking up a
lot more of your time is in the(Medicaid/State name for Medicaid) files.)
Could you give me [her/his] Medicaid number for this purpose?
(Under the Privacy Act of 1974, providing [her/his] number is (also) a voluntary
decision. Any remaining benefits under this program will not be affected in any
way by your decision)
.................................................................................
66 1. NUMBER RECORDED
29 4. R REFUSED NUMBER
201 5. NUMBER NOT RECORDED (NOT REFUSED)
19 8. DK (Don't Know); NA (Not Ascertained)
3 9. RF (Refused)
992 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UN337 OOP NON-MEDICAL EXPENSES
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
Ref: SecN.N337_
In addition to medical expenses, persons [may have other health-related/with
serious illnesses often have] non-medical expenses.
[In the last two years/Since [PREV WAVE FIRST R IW MONTH], [PREV WAVE FIRST R IW
YEAR]/[Prev Wave Iw Yr]], did [FIRST NAME] have any out-of-pocket non-medical
expenses such as modifying the house with ramps or lifts, hiring help for
housekeeping or other household chores or for assisting with personal needs?
.................................................................................
187 1. YES
1105 5. NO
12 8. DK (Don't Know); NA (Not Ascertained)
2 9. RF (Refused)
4 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
ASK:
IF N337_ = YES;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN338 OOP NON-MEDICAL COSTS- AMT
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.N338_
About how much did [she/he] [ or / or her/his you/husband/wife/partner/ /or
you] pay out-of-pocket for non-medical expenses [[since [PREV WAVE FIRST R IW
Month], [PREV WAVE FIRST R IW YEAR]/[Prev Wave Iw Yr]/since [PREV WAVE FIRST R
IW YEAR]/[Prev Wave Iw Yr]/in the last two years before her/his death]]?
IWER: DO NOT PROBE DK/RF
Amount:
.................................................................................
-----------------------------------------------------------------
N Min Max Mean SD Miss
133 0 64000 2945.74 8049.59 1123
-----------------------------------------------------------------
54 999998. DK (Don't Know); NA (Not Ascertained)
999999. RF (Refused)
==========================================================================================
*Assign N339_ := EMPTY:
IF N337_ = YES;
IF N338_ <> EMPTY AND N338_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN339 OOP NON-MEDICAL COSTS- MIN
Section: N Level: Respondent Type: Numeric Width: 6 Decimals: 0
Ref: SecN.N339_
N339-N341 Unfolding Sequence
Question text: Did it amount to less than $____ , more than $____ , or what?
PROCEDURES: 3Up1Down, 2Up2Down, 1Up3Down
BREAKPOINTS: $1,000, $5,000, $25,000, $100,000, $500,000
RANDOM ENTRY POINTS: $5,000, $25,000, $100,000
ENTRY POINT ASSIGNMENT: 1 or 2 or {NOT 1 and NOT 2} AT X513
.................................................................................
26 0. Value of Breakpoint
4 1000. Value of Breakpoint
5 1001. Value of Breakpoint
4 5000. Value of Breakpoint
9 5001. Value of Breakpoint
1 25000. Value of Breakpoint
3 25001. Value of Breakpoint
1 100001. Value of Breakpoint
1257 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N340_ := EMPTY:
IF N337_ = YES;
IF N338_ <> EMPTY AND N338_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN340 OOP NON-MEDICAL COSTS- MAX
Section: N Level: Respondent Type: Numeric Width: 10 Decimals: 0
Ref: SecN.N340_
.................................................................................
16 999. Value of Breakpoint
4 1000. Value of Breakpoint
5 4999. Value of Breakpoint
4 5000. Value of Breakpoint
9 24999. Value of Breakpoint
1 25000. Value of Breakpoint
1 99999. Value of Breakpoint
1 499999. Value of Breakpoint
12 99999996. Greater than Maximum Breakpoint
1257 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
*Assign N341_ := EMPTY:
IF N337_ = YES;
IF N338_ <> EMPTY AND N338_ <> NONRESPONSE;
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
UN341 OOP NON-MEDICAL COSTS- RESULT
Section: N Level: Respondent Type: Numeric Width: 2 Decimals: 0
Ref: SecN.N341_
.................................................................................
1 97. Data not available
12 98. DK (Don't Know); NA (Not Ascertained)
99. RF (Refused)
1297 Blank. INAP (Inapplicable); Partial Interview
==========================================================================================
UVDATE 2006 DATA MODEL VERSION
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
User Note: This variable identifies which data model was used to interview the
household. Please reference the data description for a summary of changes in
each data model.
.................................................................................
135 1. Version 1
146 2. Version 2
226 3. Version 3
761 4. Version 4
42 5. Version 5
==========================================================================================
UVERSION 2006 EXIT FINAL RELEASE VERSION NUMBER
Section: N Level: Respondent Type: Numeric Width: 1 Decimals: 0
.................................................................................
1310 1. HRS 2006 Exit Final Release
|