OPADE
Covered by other public hospital/physician managed care in December
Description
Extracts include the OPAJA-OPADE variables if users choose OPAMM during the extract process.
Codes and Frequencies
An 'X' indicates the category is available for that sample
| Code | Label |
17
|
16
|
15
|
14
|
13
|
12
|
11
|
10
|
09
|
08
|
07
|
06
|
05
|
04
|
03
|
02
|
01
|
00
|
99
|
98
|
97
|
96
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0 | NIU | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
| 1 | No | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
| 2 | Yes | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X | X |
Can't find the category you are looking for? Try the Detailed codes
Comparability
No information available.Universe
- 1996-2017: All persons in a reference period that includes December of the current year.
Availability
- 1996-2017
Survey Text
| 2017 | 2011 | 2005 | 1999 |
| 2016 | 2010 | 2004 | 1998 |
| 2015 | 2009 | 2003 | 1997 |
| 2014 | 2008 | 2002 | 1996 |
| 2013 | 2007 | 2001 | |
| 2012 | 2006 | 2000 |
2017
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2016
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2015
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2014
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2013
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2012
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2011
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2010
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2009
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2008
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2007
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2006
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2005
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2004
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2003
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2002
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2001
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
2000
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
1999
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
1998
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
1997
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
1996
Survey form
view entire document:
text
image
HX14
====
====
====
====
====
[STR-DT]
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
[During the last interview, we recorded that no one in the family was covered by any other state sponsored program which provided hospital and physician benefits.]
At any time since (START DATE), has anyone in the family had any type of health insurance obtained through any state or local government agency which provided hospital and physician benefits?
YES .................................... 1
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
HX15
NO ..................................... 2 [BOX_19]
REF ................................... -7 [BOX_19]
DK .................................... -8 [BOX_19]
PRESS F1 FOR DESCRIPTION OF INSURANCE TYPES TO INCLUDE.
----------------------------------------------------
DISPLAY FIRST PARAGRAPH ('During .... benefits.') IF NOT ROUND 1. OTHERWISE, USE A NULL DISPLAY.
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND SINGLE-PERSON RU, SELECT PERSON AT HX15 AUTOMATICALLY BY CAPI AND GO TO LOOP_07
----------------------------------------------------
----------------------------------------------------
IF HX14 IS CODED '1' (YES) AND MULTI-PERSON RU, CONTINUE WITH HX15
----------------------------------------------------
----------------------------------------------------
NOTE: 'GOVT-HOSPITAL/PHYSICIAN' SHOULD BE USED FOR THE ESTABLISHMENT NAME IN THE CONTEXT HEADER (WHERE APPROPRIATE).
----------------------------------------------------
====
[STR-DT]
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
Who is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
PROBE: Who else is covered by a program sponsored by a state or local government agency which provided hospital and physician benefits?
TO TURN CHECK MARK ON/OFF, USE ARROW KEYS, PRESS ENTER.
TO LEAVE, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
HX42
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS THE RU-MEMBERS-ROSTER.
----------------------------------------------------
====
[STR-DT]
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
Under [[Medicaid/[STATE NAME FOR MEDICAID]]/the program sponsored by a state or local government agency which provides hospital and physician benefits] (are/is) (READ NAME(S) FROM BELOW) signed up with an HMO, that is a Health Maintenance Organization?
[With an HMO, you must generally receive care from HMO physicians. If another doctor is seen, the expense is not covered unless you were referred by the HMO, or there was a medical emergency.]
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name,[Middle Name],Last Name-65]
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
PR23
[2. First Name,[Middle Name],Last Name-65]
[3. First Name,[Middle Name],Last Name-65]
YES, ALL ARE ........................... 1 [HX44]
YES, SOME ARE .......................... 2 [HX44]
NO, NONE ARE ........................... 3
REF ................................... -7
DK .................................... -8
PRESS F1 FOR DEFINITION OF HMO.
----------------------------------------------------
DISPLAY '[Medicaid/[STATE NAME FOR MEDICAID]]' IF ASKING ABOUT MEDICAID.
DISPLAY 'the program....benefits' IF ASKING ABOUT GOVT-HOSPITAL/PHYSICIAN.
----------------------------------------------------
----------------------------------------------------
DISPLAY 'Medicaid' IF STATE IN WHICH INTERVIEW IS BEING CONDUCTED USES THE NAME 'MEDICAID'. DISPLAY 'STATE NAME FOR MEDICAID' (SUBSTITUTING THE REAL STATE NAME FOR THE PROGRAM) IF THE STATE IN WHICH INTERVIEW IS BEING CONDUCTED DOES NOT USE THE NAME 'MEDICAID.' FOR THE SPECIFIC NAME TO USE BY STATE, SEE BOX ON HX06.
----------------------------------------------------
----------------------------------------------------
ROSTER DEFINITION: THIS ROSTER DISPLAYS ITEMS IN THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER THAT MEET THE FOLLOWING CONDITIONS:
- ESTABLISHMENT IS MEDICAID OR GOVT-HOSPITAL/ PHYSICIAN
AND
- PERSON IS AN RU MEMBER FLAGGED AS COVERED BY MEDICAID OR GOVT-HOSPITAL/PHYSICIAN DURING THE CURRENT ROUND
----------------------------------------------------
====
[STR-DT]
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
During the last interview, we recorded that (READ NAME(S) BELOW) (was/were) covered by a program sponsored by a state or local government agency which provided hospital and physician benefits.
Have all of these people been covered by a program sponsored by a state or local government agency at any time since (START DATE)?
TO SCROLL, USE ARROW KEYS.
TO LEAVE BOX AND GO TO ENTRY FIELD, PRESS ESC.
[1. First Name, [Middle Name], Last Name-65]
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
[2. First Name, [Middle Name], Last Name-65]
[3. First Name, [Middle Name], Last Name-65]
YES, ALL .............................. 1
NO, ONLY SOME ......................... 2
NO, NONE .............................. 3
REF ................................... -7 [BOX_11]
DK .................................... -8 [BOX_11]
PRESS F1 FOR DEFINITION OF THIS TYPE OF PROGRAM.
-----------------------------------------------------
ROSTER DEFINITION: THIS ITEM DISPLAYS ALL PERSONS ON THE RU-ESTABLISHMENT-PERSON-PAIRS-ROSTER WHO WERE COVERED BY GOVT-HOSPITAL/PHYSICIAN AT ANY TIME DURING THE PREVIOUS ROUND.
-----------------------------------------------------
----------------------------------------------------
IF CODED '1' (YES, ALL), FLAG ALL RU MEMBERS LISTED HERE AS 'COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND. THEN GO TO BOX_09
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE), FLAG ALL RU MEMBERS LISTED HERE AS 'NOT COVERED BY GOVT-HOSPITAL/ PHYSICIAN' DURING CURRENT ROUND.
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ANY CURRENT RU MEMBERS NOT LISTED AT PR23, GO TO PR25
----------------------------------------------------
----------------------------------------------------
IF CODED '3' (NO, NONE)
AND
IF ALL CURRENT RU MEMBERS ARE LISTED AT PR23, GO TO BOX_11
----------------------------------------------------
----------------------------------------------------
IF CODED '2' (NO, NONE), CONTINUE WITH PR24
----------------------------------------------------
Weights
- 1996-2017 : PERWEIGHT