Survey Text

2016 2011 2006 2001
2015 2010 2005 2000
2014 2009 2004 1999
2013 2008 2003 1998
2012 2007 2002 1997
top
2016
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2015
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2014
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2013
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2012
Survey form view entire document:  text  image
ER12
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
Was there anyone else?
PROBE: Were there any other doctors or surgeons who treated (PERSON) during the emergency room visit and who (PERSON) (have/has) seen at a place of practice outside of (PROVIDER)?
YES .................................... 1
NO ..................................... 2
REF ................................... -7
DK .................................... -8
----------------------------------------------------
NOTE: IN ROUNDS 1 AND 2 THE PROBE PART OF THE QUESTION WAS WORDED, "...and who have a place of practice outside of (PROVIDER) where (PERSON) (was/were) seen as a patient?"
----------------------------------------------------

top
2011
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2010
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2009
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2008
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2007
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2006
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2005
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2004
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2003
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2002
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2001
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
2000
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
1999
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
1998
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------

top
1997
Survey form view entire document:  text  image
OP02
====

[PERSON'S FIRST MIDDLE AND LAST NAME] [NAME OF MEDICAL CARE PROVIDER......] [EVN-DT]
OUTPATIENT DEPT. NAME: [OUTPATIENT DEPT NAME FROM OP01]
Did (PERSON) visit the (OUTPATIENT DEPARTMENT) at (PROVIDER) on (VISIT DATE) in person or was this a telephone call?
SAW PROVIDER ........................... 1
TELEPHONE CALL ......................... 2
REF ................................... -7
DK .................................... -8
[Code One]
----------------------------------------------------
DISPLAY THE TEXT ENTRY FROM OP01 FOR 'OUTPATIENT DEPT NAME FROM OP01'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '1' (SAW PROVIDER), FLAG EVENT AS 'OP-IN-PERSON'.
----------------------------------------------------
----------------------------------------------------
IF OP02 IS CODED '2' (TELEPHONE CALL), '-7' (REFUSED), OR '-8' (DON'T KNOW) FLAG EVENT AS 'OP-TELEPHONE'.
----------------------------------------------------