unique identifier
call type
status
date of interview
i am calling on behalf of the state of oh dept of health and oh state university
we realize that we are contacting people on their cell phones. your safety is im
are you in a location where talking on the phone could jeopardize your safety or
thank you, are you 18 years of age or older?
are you a resident of ohio?
we are conducting a survy on health insurance coverage, use of medical services,
first, do you live in a residential household, such as an apartment, a house, or
how long have you lived in ohio? has it been less than a month, more than a mon
your telephone number was chosen randomly and all information will be kept stric
may i speak with an adult/another adult?
first, have i reached you at a residential household, such as an apartment, a ho
i need to randomly select one adult who lives in your household to be interviewe
are you the adult?
just to confirm, you said that there are no adults, 18 years of age or older in
now, i would like to identify the adult currently living in your household, 18 o
could i have your 1st name or initials?
may i speak to someone who knows about the household member's birthdays?
is \:s1i: available now?
could you please ask \:s1i: to come to the telephone and answer some questions?
do you know about \:s1i:'s health insurance?
what is your relationship to \:s1i:?
how would you describe your relationship to \:s1i:?
i have another question about your age before i ask you about \:s1i:. please tel
who could i speak to that knows about \:s1i:'s insurance?
could i have a 1st name or initials of this person.
could you please ask \:s4int: to come to the telephone and answer some questions
hello, my name is, and i am calling on behalf of the state of oh dept of health
before i start asking about \:s1i:, i need to ask about your relationship to \:s
please tell me how old you were on your last birthday.
how many children, persons 17 years of age or younger, live in this household wh
how long [have you][has :pername:] lived in ohio? has it been less than a month,
in what county in the state of oh [do you][does :pername:] live?
interviewer record the county name here --- ask for spelling if necessary.
including [yourself][:pername:], how many adult members of [your'[his][her] fami
earlier i had recorded that there were [fill in] adults living in [your][:pernam
how many children, persons 17 years of age or younger, in [your][:sli:'s] family
let me see if i have this right. i thought you just told me that there were |s12
[are you][is :pername:] a parent of a child 17 years of age or younger living wi
please tell me how old [you were][:pername: was] on [your][his][her] last birthd
on [your][:pername:'s] last birthday would you say that [you were][:pername: was
what is [your][:pername:'s] gender?
[are you][is :pername:] covered by health insurance or some other type of health
health insurance or some other type of health care plan may include... keeping t
[are you][is :pername:] covered by a health insurance plan through a current or
is that insurance through [your][:pername:'s] work or [are you][is :pername:] re
just to confirm, you said that [your][:pername:'s] insurance is through [your ow
is that through [your][:pername:'s] current work or past work? / [are you][is :p
[do you][does :pername:] have an adult child or children between the ages of 18
how many of these adult children between the ages of 18 and 28 are currently uni
[are you][is :pername:] covered by medicare, the federal government-funded healt
[are you][is :pername:] covered by medicaid, the state of oh government health c
which medicaid plan [are you][is :pername:] covered by? read if necessary: is it
what is the name of the medicaid plan [are you][is :pername:] is covered by?
just to verify, [are you][is :pername:] covered by the state medicaid program or
confirmed/calculated medicare
confirmed/calculated medicaid
and [you are][:pername: is] [fill in]. is that correct?
[do you][does :pername:] have military or veterans coverage such as tricare or c
[are you][is :pername:] covered by health insurance purchased directly, that is,
[do you][does :pername:] have any other health care coverage that i have not men
to confirm, you said [you are][:pername: is] covered by [fill in]. is that corre
is [your][:pername:'s] primary health insurance plan family coverage, single cov
how would you describe [your][:pername:'s] primary health insurance plan?
enter response
is the annual deductible for medical care for this plan less than $1,100 or $1,1
is the family annual deductible for medical care for this plan less than $2,200
do any of [your][:pername:'s] current health insurance plans cover dental care e
do any of [your][:pername:'s] current health insurance plans cover prescription
how long [have you][has :pername:] been covered by [your][:pername:] current pri
interviewer: enter number of days
interviewer: enter number of weeks
interviewer: enter number of months
interviewer: enter number of years
earlier i thought you said that [your][:pername:'s] age was [fill in] and now i'
computed from b18 - converted to days
just prior to [your][:pername:'s] current health insurance coverage, [were you][
what was the main reason [your][:pername:'s] previous health insurance ended?
describe the main reason [your][:pername:'s] previous health insurance ended.
[were you][was :pername:] covered by any other insurance that [you][:pername:] o
just prior to [your][:pername:'s] current health insurance coverage, were [you][
during the past 12 months, was there any time that [you][:pername:] did not have
during the past 12 months, how long [were you][was :pername:] without health ins
computed from b27 - converted to days
during the past 12 months, did any of the following things happen to [you][:pern
did [you][:pername:] delay or avoid getting care because [you were][he or she wa
did [you][:pername:] have any problems getting the care [you][:pername:] needed
did [you][:pername:] have any major medical costs?
did [you][:pername:] delay or avoid getting care that [you][:pername:] felt [you
did [you][:pername:] have any problems getting the care [you][:pername:] needed?
during the past 12 months, at any time [were you][was :pername:] covered by any
when was the last time [you][:pername:] had health insurance coverage?
computed from c2 - converted to days
the last time [you][:pername:] had health insurance [were you][was :pername:] co
the last time [you][:pername:] had health insurance, [were you][was :pername:] c
computed from c6 - converted to days
let me see if i have this right, earlier i thought you said that [your][:pername
computed from c26 - converted to days
in general, would you say [you][:pername:'s] health is excellent, very good, goo
how many days during the past 30 days was [your][:pername:'s] physical health no
for how many days during the past 30 days did a mental health condition or emoti
during the past 30 days, how often did [you][:pername:] feel ... so sad that not
during the past 30 days, how often did [you][:pername:] feel ... nervous?
during the past 30 days, how often did [you][:pername:] feel ... restless or fid
during the past 30 days, how often did [you][:pername:] feel ... hopeless?
during the past 30 days, how often did [you][:pername:] feel ... that everything
during the past 30 days, how often did [you][:pername:] feel ... worthless?
[do you][does :pername:] have difficulty doing or need assistance to do day-to-d
is this because of any medical, mental health or other health condition?
is this a condition that has lasted or is expected to last for at least 12 month
[do you][does :pername:] need or get special therapy?
[do you][does :pername:] need or get treatment or counseling for any kind of men
has this problem lasted or is it expected to last for at least 12 months?
assistance with personal care, such as bathing, dressing, toileting, or feeding?
domestic assistance, such as shopping, laundry, housekeeping, cooking, or transp
social or emotional support, such as companionship, recreation, and socializatio
coordinating health care, such as making appointments for doctor's visits or the
[have you][has :pername:] smoked at least 100 cigarettes in [your][:pername:] en
[do you][does :pername:] smoke cigarettes every day, some days, or not at all?
[have you][has :pername:] used snuff or chewing tobacco at least 20 times in [yo
[do you][does :pername:] now use snuff or chewing tobacco?
during the past 30 days, on how many days did [you][:pername:] have at least one
during the past 30 days, considering all types of alcoholic beverages, on how ma
during the past 7 days, how many times did [you][:pername:] drink a can, bottle,
about how much [do you][does :pername:] weigh without shoes?
record weight (pounds)
record weight (kilograms)
computed from d30a - converted to lbs
about how tall [are you][is :pername:] without shoes?
record feet and inches
record height in centimeters
computed from d30b - converted to inches
about how long has it been since [you][:pername:] last saw a doctor or other hea
computed from e59 - converted to days
i want to make sure i have this right, [you have][:pername: has] never visited a
about how long has it been since [you][:pername:] last visited a doctor for a ro
let me see if i have this right, earlier i thought you said [fill in]. however,
computed from e59a - converted to days
during the past 12 months, how many times [were you][was :pername:] a patient in
during the past 12 months, did [you][:pername:] go to the emergency room because
about how long has it been since [you][:pername:] last visited a dentist? includ
computed from e63 - converted to days
is there one place that [you][:pername:] usually [go][goes] to when [you are][:p
just to be sure, is it that there is no place at all that [you][:pername:] usual
what kind of place is it? a clinic or health center, a doctor's office or hmo, a
is there a place [you][:pername:] could get an appointment to see a medical prov
from the time [you][:pername:] leave home, on average, about how long does it ta
computed from f67c1 - converted to minutes
interviewer: you've just entered [fill in]. is that correct?
during the past 12 months, did [you][:pername:] need to see a specialist to get
how much of a problem, if any, was it for [you][:pername:] to see a specialist?
during the past 12 months, was there a time when [you][:pername:] needed dental
in the past 12 months, [have you][has :pername:] not filled a prescription becau
during the past 12 months, was there a time when [you][:pername:] needed vision
during the past 12 months, was there any time when [you][:pername:] did not get
what was the health care that [you][:pername:] needed but did not get? (1st resp
what was the health care that [you][:pername:] needed but did not get? (2nd resp
what was the health care that [you][:pername:] needed but did not get? (3rd resp
what was the health care that [you][:pername:] needed but did not get? (4th resp
what was the health care that [you][:pername:] needed but did not get? (5th resp
what was the health care that [you][:pername:] needed but did not get? (6th resp
what was the health care that [you][:pername:] needed but did not get? (7th resp
what was the health care that [you][:pername:] needed but did not get? (8th resp
what was the health care that [you][:pername:] needed but did not get? (9th resp
what was the health care that [you][:pername:] needed but did not get? (10th res
record other healthcare needed but did not get
compared to three years ago, is getting the medical care [you][:pername:] becom
during the last 12 months, were there times when [you][:pername:] had problems p
have any of the following happened because [you][:pername:] had to pay medical b
used up all or most of [your][:pername:'s] savings?
had large credit card debt or had to take a loan or debt against [your][:pername
had to declare bankruptcy?
[are your][is :pername:] living quarters: owned or being bought by [fill in], re
during the past 12 months, was there a time when [you][your family][:pername:'s
did [you][:pername:] get any financial help when [you][he][she] were not able to
during the last 12 months, did [you][:pername:] or [your children][:pername:'s c
if [you][:pername:] lost all current source(s) of household income, how long cou
which of these items does [your][:pername:'s] household now have? home heating s
which of these items does [your][:pername:'s] household now have? a refrigerator
which of these items does [your][:pername:'s] household now have? a television
which of these items does [your][:pername:'s] household now have? a computer
which of these items does [your][:pername:'s] household now have? seasonal cloth
which of these items does [your][:pername:'s] household now have? a car or truck
which of these items does [your][:pername:'s] household now have? a stove for co
which of these items does [your][:pername:'s] household now have? water in the h
last week did [you][:pername:] have a job either full or part-time? include any
what is the main reason [you][:pername:] did not work/have a job or business las
[do you][does :pername:] work for the government, private industry, or [are you]
how would you describe where [you][:pername:] [work][works]?
enter description
does [your][:pername:'s] employer or union offer a health insurance plan to any
does [your][:pername:'s] employer or union offer coverage to employees only, or
who does the employer or union offer coverage to?
you may have already told me this, but [are you][is :pername:] currently eligibl
not participating in employer or union health insurance plan because the plan co
why [are you][is :pername:] not participating in [your][his][her] employer or un
[are you][is :pername:] ineligible because [you have][she/he has] not worked lon
why [are you][is :pername:] not eligible?
how many hours per week [do you][does :pername:] usually work at [your][his][her
[do you][does :pername:] usually work less than 35 hours per week or 35 or more
what is the main reason [you][:pername:] usually work less than 35 hours per wee
counting all locations where [your][:pername:'s] employer operates or operated i
do you think it is more or less than 50 people?
including [you][:pername:] and all adults and children in [your][:pername:'s] ho
including all adults and children, of the total number of persons in your househ
[are you][is :pername:] ... ?
what is [your][:pername:'s] partner's gender?
is [your][:pername:'s] spouse or partner currently employed?
what is the highest level of school [you have][:pername: has] completed or the h
[are you][is :pername:] of hispanic or latino origin?
which one or more of the following would you say is [your][:pername:'s] race? (1
which one or more of the following would you say is [your][:pername:'s] race? (2
which one or more of the following would you say is [your][:pername:'s] race? (3
which one or more of the following would you say is [your][:pername:'s] race? (4
which one or more of the following would you say is [your][:pername:'s] race? (5
which one or more of the following would you say is [your][:pername:'s] race? (6
which one or more of the following would you say is [your][:pername:'s] race? (7
how would you describe [your][:pername:'s] race?
interviewer: enter race.
which of these groups, that is ... [fill in] would you say best represents [your
do you consider [yourself][:pername:] to be white hispanic, black hispanic, asia
enter race.
[have you][has :pername:] ever served in the united states armed forces? this in
did [you][:pername:] ever serve in a combat or war zone?
what years did [you][:pername:] serve in a combat or war zone?
computed (s11+s13)
please tell me [your][:pername:'s] total gross income during the calendar year 2
yearly income.
monthly income.
computed from h85 - converted to yearly income
which category represents the total combined income of all members of this famil
your response would really help the survey sponsors understand how lower and hig
computed from h86
autocode of 63% fpl
autocode of 100% fpl
autocode of 138% fpl
autocode of 150% fpl
autocode of 200% fpl
autocode of 250% fpl
autocode of 300% fpl
autocode of 400% fpl
computed (s10+s12)
what is the total income received last month, [fill in] 2010, by [your][:pername
please tell me [your][:pername:'s] total household gross income during the calen
computed from h89 - converted to yearly income
please tell me [your][:pername:'s] total income during the calendar year 2009. t
computed from nh85 - converted to yearly income (2nd time)
computed from nh86
autocode of 63% fpl (2nd time)
autocode of 100% fpl (2nd time)
autocode of 138% fpl (2nd time)
autocode of 150% fpl (2nd time)
autocode of 200% fpl (2nd time)
autocode of 250% fpl (2nd time)
autocode of 300% fpl (2nd time)
autocode of 400% fpl (2nd time)
you had mentioned that there were other members of [your][:pername:'s] household
computed from nh89 - converted to yearly income (2nd time)
is [your][:pername:'s] total household gross income during the calendar year 200
we have a few questions about the general characteristics of [your][:pername:'s]
is this telephone line the main line into [your][:pername:'s] home?
at any time, during the past 12 months, had [your][:pername:'s] household been w
for how long did [you][:pername:] not have telephone service during the past 12
computed from q156 - converted to days
what is the main reason that [you][:pername:] did not have telephone service at
enter reason
is [your][:pername:'s] place of residence/home built before the year 1950?
[do you][does :pername:] consider [yourself][:pername:] to be:
[do you][does :pername:] personally use a cell phone?
how many cell phones [do you][does :pername:] use for receiving calls?
during the most recent time [you][:pername:] or [your][:pername:'s] family were
of all the telephone calls that [you][:pername:] or [your][:pername:'s] family r
the next questions are about different types of violence in relationships with a
has an intimate partner ever used physical violence against you? this includes h
when was the last time an intimate partner used physical violence against you?
computed from r3 - converted to days
thinking about the last time an intimate partner used physical violence against
are guns of any kind kept in [your][:pername:'s] household?
earlier you said there was one child in [your][:pername:'s] family. what is that
interviewer: child's name, nickname or initials.
please tell me how old [:childname:][the child] was on his or her last birthday.
would you be able to answer just 2 to 4 of the most important questions before w
what is [your][:pername:'s] relationship to [:childname:][the child]?
how would you describe [your][:pername:'s] relationship to [:childname:][the chi
enter relationship
i would now like to speak to someone in this household who best knows about [:ch
what is that person's 1st name?
enter name
is \:i91b: available?
could you please ask \:i91b: to come to the telephone and answer some questions?
hello, my name is...
what is your relationship to [:childname:][the child]?
how would you describe your relationship to [:childname:][the child]?
last week was [:childname:][the child] covered by health insurance or some other
would you be able to answer just one of the most important questions before we e
last week, was [:childname:][the child]'s health insurance coverage the same as
so, the health insurance coverage that [:childname:][the child] has is [fill in[
is [:childname:][the child] covered by a health insurance plan through someone's
is [:childname:][the child] covered by medicare, the federal government-funded h
just to confirm, you said that [:childname:][the child] is covered by medicare,
is [:childname:][the child] covered by medicaid, the state of oh government heal
which medicaid plan is [:childname:][the child] covered by? (1st response)
which medicaid plan is [:childname:][the child] covered by? (2nd response)
what is the name of the medicaid plan [:childname:][the child] is covered by?
is [:childname:][the child] covered by military or veterans coverage, such as tr
is [:childname:][the child] covered by health insurance purchased directly, that
is [:childname:][the child] covered by the bureau for children with medical hand
what is the name of that program?
enter plan name
to confirm, you said [:childname:][the child] is covered by [fill in]. is that c
do any of [:childname:][the child]'s current insurance plans cover ... dental ca
do any of [:childname:][the child]'s current insurance plans cover ... prescript
how long has [:childname:][the child] been covered by his or her current primary
computed from j113 - converted to days
just prior to [:childname:][the child]'s current health insurance coverage, was
just prior to [:childname:][the child]'s current health insurance coverage was [
was this prior health insurance coverage just prior to [:childname:][the child]'
what was the main reason [:childname:][the child]'s previous health insurance en
was [:childname:][the child] covered by any other insurance that you or your fam
was there any time in the past 12 months that [:childname:][the child] did not h
during the past 12 months, how long was [:childname:][the child] without health
computed from j122 - converted to days
during the past 12 months, did any of the following things happen to [:childname
did you or your family delay or avoid getting care for [:childname:][the child]
did you or your family have any problems getting the care [:childname:][the chil
did you or your family have any problems getting needed care for [:childname:][t
at any time during the past 12 months, was [:childname:][the child] covered by a
did anyone try to get medicaid, healthy families, or healthy start for [:childna
did any of the following things happen to [:childname:][the child] while he or s
in general, how would you describe [:childname:][the child]'s health? would you
how tall is [:childname:][the child] now?
computed from l125a1 - converted to inches
how much does [:childname:][the child] weigh now?
computed from l125a2 - converted to lbs
does [:childname:][the child] currently need or use medicine prescribed by a doc
is [:childname:][the child] in need for prescription medicine because of any med
is this a condition that has lasted or is expected to last 12 months or longer?
does [:childname:][the child] need or use more medical care, mental health or ed
is [:childname:][the child] in need of medical care, mental health or educationa
is [:childname:][the child] limited or prevented in any way in his or her abilit
does [:childname:][the child] have any limitation in abilities because of any me
does [:childname:][the child] need or get special therapy, such as physical, occ
is [:childname:][the child] in need for special therapy because of any medical,
does [:childname:][the child] have any kind of emotional, developmental or behav
has [:childname:][the child]'s emotional, developmental or behavorial problem la
[since his or her birth][in the past 12 months] did [:childname:][the child] rec
not including overnight hospital stays, visits to hospital emergency rooms, home
computed from m131 - converted to days
i want to make sure i have this right, [:childname:][the child] has never visite
during the past 12 months, how many times was [:childname:][the child] a patient
about how long has it been since [:childname:][the child] last visited a dentist
computed from m135 - converted to days
is there a place that [:childname:][the child] usually goes when he or she is si
just to be sure, is it that there is no place at all that [:childname:][the chil
is it a doctor's office, emergency room, hospital outpatient department, clinic,
what kind of place does [:childname:][the child] go to most often? is it a clini
what kind of place does [:childname:][the child] go to most often?
do you have one or more persons you think of as [:childname:][the child]'s perso
during the past 12 months, was there a time when [:childname:][the child] needed
in the past 12 months, has [:childname:][the child] not had a prescription fille
during the past 12 months, was there any time when [:childname:][the child] did
what is [:childname:][the child]'s gender?
is [:childname:][the child] of hispanic or latino origin?
which one or more of the following would you say is [:childname:][the child]'s r
how would you describe [:childname:][the child]'s race?
which of these groups, that is would you say best represents [:childname:][the c
do you consider [:childname:][the child] to be white hispanic, black hispanic, a
you may have mentioned this already, but are either of [:childname:][the child]'
the following questions are for you - the interviewer to answer. interviewer: ov
interviewer: how would you (the interviewer) rate the quality of the information
interviewer: what were the reasons that the quality of information was less than
enter other reason
language interview conducted in:
numeric variable stratum for variance estimation
region
final adult weight
final child weight
race-ethnicity adult, 4 categories, imputed
race-ethnicity child, 4 categories, imputed when inttype=2
level of education, imputed
annual income, h85y_1, imputed
number of persons in the family, imputed
h86 imputed
h87 imputed
age child years, imputed when inttype=2
number of phone lines, imputed
number of adults in the family, imputed
gender, imputed
medicaid adult, imputed
medicaid child, imputed
own or rent, imputed
recovery marker
adult or adult/child interview
proxy's age
adult's age
child's age
delayed treatment - adult
delayed treatment - child
adult - type of coverage
level of education
employer size
employer size over 50 ppl
adult - number of er visits
child - number of er visits
household composition
adult hispanic ethnicity
child hispanic ethnicity
getting needed medical care - adult
getting needed medical care - child
ability to get health care
work 35 hours or more per week
enrolled in emplyer plan-whose employer
insured by own current employer
adult insurance status
child insurance status
adult insurance type
child insurance type
dental care coverage
prescription med coverage
major medical costs - adult
major medical costs - child
marital status
adult uses medicaid
child uses medicaid
other problems getting treatment - adult
other problems getting treatment - child
income as a % of poverty
adult - previous insurance type
adult's race
child's race
relationship of proxy to respondent
relationship of child to proxy
adults w/ or w/o spcial hlth care needs
chldren w/ or w/o spcial hlth care needs
adult -needing specialist care
adult - problem seeing a specialist
length of time uninsured, adult
usual source of care - adult
usual source of care - child
adult - mean # of er visits
child - mean # of er visits
body mass index - adult
bmi category - adult
90% fpl flag
138% fpl flag
last month income (2010), imputed
adult age years, imputed
gender child, imputed when inttype=2