Table 2.
Patient self-report of health service utilisation
INSTRUCTIONS: Thinking about your use of health services over the last (7 days/3 months)... |
Have you received an x-ray in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you attended radiology for an x-ray in the last (7 days/last 3 months)? |
Have you been hospitalised in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you been hospitalised in the last (7 days/last 3 months)? |
Have you visited casualty/emergency in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you visited casualty/emergency in the last (7 days/last 3 months)? |
Have you visited an outpatient or day clinic in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you visited an outpatient or day clinic in the last (7 days/3 months)? |
Have you visited any GP in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you visited a GP in the last (7 days/3 months)? |
Have you visited a medical/surgical specialist in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you visited a specialist in the last (7 days/3 months)? |
Have you visited any physiotherapist in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you consulted a physiotherapist in the last (7 days/3 months)? |
Have you visited any osteopath in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you visited an osteopath in the last (7 days/3 months)? |
Have you visited any chiropractor in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you visited a chiropractor in the last (7 days/3 months)? |
Have you visited any other health provider (OHP1) in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you visited OHP1 in the last (7 days/3 months)? |
Have you visited any other health provider (OHP2) in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many times have you visited OHP2 in the last (7 days/3 months)? |
Have you used any prescription or over-the-counter medications in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, how many different medications have you used in the last (7 days/3 months)? |
Have you used any prescription or over-the-counter pain relievers in the last (7 days/3 months)?(YES/NO/NOT SURE) |
If yes, on how many days have you taken pain relievers in the last (7 days/3 months)? |
Have you used any prescription or over-the-counter sleeping medications in the last (7 days/3 months)? (YES/NO/NOT SURE) |
If yes, on how many days have you taken sleeping medications in the last (7 days/3 months)? |
INSTRUCTIONS: Thinking about your usual main activity over the last (7 days/3 months)... |
What is your usual main activity? |
Full-time student |
Part-time student |
Employed |
Unemployed |
Not applicable |
How many hours would you usually spend on your main activity in a week? |
0 hours |
1–15 hours |
16–24 hours |
25–34 hours |
40 hours |
41–48 hours |
49 hrs or more |
Have you spent time away from your usual main activity due to illness or to attend treatment in the last (7 days/3 months)?(YES/NO/NOT SURE) |
If yes, how many full days away from usual main activity due to illness in the last (7 days/3 months)? |
And how many hours away from usual main activity to attend treatment in the last (7 days/3 months)? |