Survey Text

2017 2011 2005 1999
2016 2010 2004 1998
2015 2009 2003 1997
2014 2008 2002
2013 2007 2001
2012 2006 2000
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2017
Survey form view entire document:  text  image
Question ID:FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text:
? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [go to IPIHNO]
(2,R,D) [if an injury episode, go to IMTRAF; if a poisoning episode, go to PPOIS]

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2016
Survey form view entire document:  text  image
Question ID:FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text:
? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [go to IPIHNO]
(2,R,D) [if an injury episode, go to IMTRAF; if a poisoning episode, go to PPOIS]

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2015
Survey form view entire document:  text  image
Question ID:FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text:
? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [go to IPIHNO]
(2,R,D) [if an injury episode, go to IMTRAF; if a poisoning episode, go to PPOIS]

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2014
Survey form view entire document:  text  image
Question ID:FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text:
? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [go to IPIHNO]
(2,R,D) [if an injury episode, go to IMTRAF; if a poisoning episode, go to PPOIS]

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2013
Survey form view entire document:  text  image
Question ID:FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text:
? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [go to IPIHNO]
(2,R,D) [if an injury episode, go to IMTRAF; if a poisoning episode, go to PPOIS]

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2012
Survey form view entire document:  text  image
Question ID:FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text:
? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [go to IPIHNO]
(2,R,D) [if an injury episode, go to IMTRAF; if a poisoning episode, go to PPOIS]

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2011
Survey form view entire document:  text  image
Question ID:FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text:
? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [go to IPIHNO]
(2,R,D) [if an injury episode, go to IMTRAF; if a poisoning episode, go to PPOIS]

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2010
Survey form view entire document:  text  image
Question ID:FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text:
? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [go to IPIHNO]
(2,R,D) [if an injury episode, go to IMTRAF; if a poisoning episode, go to PPOIS]

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2009
Survey form view entire document:  text  image
Question ID: FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text: ? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [goto IPIHNO]
(2,R,D) [if an injury episode, goto IMTRAF; if a poisoning episode, goto PPOIS]

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2008
Survey form view entire document:  text  image
Question ID: FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text: ? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [goto IPIHNO]
(2,R,D) [if an injury episode, goto IMTRAF; if a poisoning episode, goto PPOIS]

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2007
Survey form view entire document:  text  image
Question ID: FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text: ? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [goto IPIHNO]
(2,R,D) [if an injury episode, goto IMTRAF; if a poisoning episode, goto PPOIS]

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2006
Survey form view entire document:  text  image
Question ID: FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text: ? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [goto IPIHNO]
(2,R,D) [if an injury episode, goto IMTRAF; if a poisoning episode, goto PPOIS]

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2005
Survey form view entire document:  text  image
Question ID: FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text: ? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [goto IPIHNO]
(2,R,D) [if an injury episode, goto IMTRAF; if a poisoning episode, goto PPOIS]

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2004
Survey form view entire document:  text  image
Question ID: FIJ.090_00.000

Instrument Variable Name: IPHOSP
Question Text: ? [F1]
[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?
1 Yes
2 No
7 Refused
9 Don't know
Universe Text: All injury/poisoning episodes for which a medical professional was consulted
Skip Instructions:
(1) [goto IPIHNO]
(2,R,D) [if an injury episode, goto IMTRAF; if a poisoning episode, goto PPOIS]

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2003
Survey form view entire document:  text  image
FIJ.045

Where did {you/subject name} receive MEDICAL ADVICE OR TREATMENT for this injury/poisoning? Anywhere else?

FR: SHOW FLASHCARD F3. MARK ALL THAT APPLY. ENTER (N) FOR NO MORE.

(1) Yes
(2) No
(7) Refused
(9) Don't know
Card F3
You may choose more than one.
1. Did not receive medical treatment or advice
2. Phone call to doctor or health care professional
3. Phone call to Poison Control Center
4. Visit to Doctor's Office
5. Visit to Clinic or Outpatient department
6. Visit to Emergency department
7. Hospitalized for at least one night
IJMED_2 (2) Phone call to doctor or health care professional
IJMED_3 (3) Phone call to Poison Control Center
IJMED_4 (4) Visit to Doctor's Office
IJMED_5 (5) Visit to Clinic or Outpatient department
IJMED_6 (6) Visit to Emergency department
IJMED_7 (7) Visit to Hospital (stayed at least one night) (FIJ.047)
[If IJMED_2 to IJMED_7 equal 2, skip to FIJ.046]

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2002
Survey form view entire document:  text  image
FIJ.045

Where did {you/subject name} receive MEDICAL ADVICE OR TREATMENT for this injury/poisoning? Anywhere else?

FR: SHOW FLASHCARD F3. MARK ALL THAT APPLY. ENTER (N) FOR NO MORE.

(1) Yes
(2) No
(7) Refused
(9) Don't know
Card F3
You may choose more than one.
1. Did not receive medical treatment or advice
2. Phone call to doctor or health care professional
3. Phone call to Poison Control Center
4. Visit to Doctor's Office
5. Visit to Clinic or Outpatient department
6. Visit to Emergency department
7. Hospitalized for at least one night
IJMED_2 (2) Phone call to doctor or health care professional
IJMED_3 (3) Phone call to Poison Control Center
IJMED_4 (4) Visit to Doctor's Office
IJMED_5 (5) Visit to Clinic or Outpatient department
IJMED_6 (6) Visit to Emergency department
IJMED_7 (7) Visit to Hospital (stayed at least one night) (FIJ.047)
[If IJMED_2 to IJMED_7 equal 2, skip to FIJ.046]

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2001
Survey form view entire document:  text  image
FIJ.045

Where did (you/subject name) receive MEDICAL ADVICE OR TREATMENT for this injury/poisoning? Anywhere else?

FR: MARK ALL THAT APPLY. ENTER (N) FOR NO MORE.
IJMED
(1) Did not receive medical treatment or advice (FIJ.046)
(2) Phone call to doctor or health care professional
(3) Phone call to Poison Control Center
(4) Visit to Doctor's Office
(5) Visit to Clinic or Outpatient department
(6) Visit to Emergency department
(7) Visit to Hospital (stayed at least one night) (FIJ.047)
(97) Refused
(99) Don't Know

[If IJMED not equal to 01 or 07, skip to FIJ.050]

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2000
Survey form view entire document:  text  image
FIJ.045

Where did (you/subject name) receive MEDICAL ADVICE OR TREATMENT for this injury/poisoning? Anywhere else?

FR: MARK ALL THAT APPLY. ENTER (N) FOR NO MORE.
IJMED
(1) Did not receive medical treatment or advice (FIJ.046)
(2) Phone call to doctor or health care professional
(3) Phone call to Poison Control Center
(4) Visit to Doctor's Office
(5) Visit to Clinic or Outpatient department
(6) Visit to Emergency department
(7) Visit to Hospital (stayed at least one night) (FIJ.047)
(97) Refused
(99) Don't Know

[If IJMED not equal to 01 or 07, skip to FIJ.050]

FIJ.046

FR: PLEASE VERIFY:

(You/subject name) DID NOT receive any medical treatment or advice for this injury/poisoning - even a phone call to a doctor's office for advice. Is that correct?
IJMED_M
(1) Make correction
(2) Proceed

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1999

No questionnaire text is available for this sample.


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1998

No questionnaire text is available for this sample.


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1997
Survey form view entire document:  text  image
FIJ.240

{Were/Was} {you/subject's name} hospitalized for at least one night as a result of this injury/these injuries?
IHOSP
(1) Yes (FIJ.250)
(2) No (Check Item FIJCCI1)
(7) Refused (Check Item FIJCCI1)
(9) Don't know (Check Item FIJCCI1)