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hhf3:page_2

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AHS2 > Hospitalization and History Forms > HFF3

HHF3: Page 2

Notes

  • Variable names are not yet converted: currently listed variable names are non-existent placeholders.

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Page 2 Page 2A

Questions

Question 3 (Second Hospitalization)

Variable name Description Notes
HOSPNAME2 HOSPITAL NAME
HOSPADR2 ADDRESS
HOSPCITY2 CITY
HOSPSTATE2 STATE
HOSPZIP2 ZIPCODE
HOSPMOYR2 MONTH AND YEAR
HOSPCAUSE2 REASON FOR HOSPITALIZATION

Question 4 (THREE OR MORE HOSPITALIZATION)

Variable name Description Notes
MORE3HOSP IF YOU HAVE THREE OR MORE HOSPITAL STAY

Question 5 (Any Cancer/Tumors Diagnosed During Hospitalizations)

Variable name Description Notes
HOSPCANDX DIAGNOSED WITH CANCER DURING HOSPITALIZATION
HOSPCANDX1 DIAGNOSED IN 1ST HOSP
HOSPCANDX2 DIAGNOSED IN 2ND HOSP
HOSPCANDX3 DIAGNOSED IN 3RD HOSP
Variable name Description Notes
MI DIAGNOSED WITH MIOCARDIAL/INFARCTION-RELATED DURING HOSP
MIY1 DIAGNOSED IN 1ST HOSP
MIY2 DIAGNOSED IN 2ND HOSP
MIY3 DIAGNOSED IN 3RD HOSP

Question 7 (First Cancer or Tumor Diagnosed NOT Requiring Hospitalization)

Variable name Description Notes
DRCANDX TUMORS DIAGNOSED NOT REQUIRING HOSPITALIZATION
DRCANLOC1 LOCATION OF TUMOR
DXMOYR1 MONTH AND YEAR OF DIAGNOSIS
DRNAME1 PHYSICIAN NAME
DRADR1 ADDRESS
DRCITY1 CITY
DRSTATE1 STATE
DRZIP1 ZIPCODE

Question 8 (MORE THAN ONE CANCER NOT Requiring Hospitalization)

Variable name Description Notes
MORECAN IF YOU HAVE ONE MORE CANCER NOT REQUIRING HOSPITALIZATION
hhf3/page_2.txt · Last modified: 2019/06/12 21:11 by msamardzija