Household Number
Member's Serial Number
place of treatment
What was the problem or reason for having a consultation, the LAST time received
Now I want to ask you about the time that you consulted health care providers, f
Who was the MAIN person you consulted at each place?
Who referred you to or suggested you use this service?
How long did it take you to travel to that place? (hour)
How long did it take you to travel to that place? (minute)
Was this consultation planned in advance or an emergency?
Did the provider prescribe any medicines?
Was the medicine prescribed easily available, either near the facility or near y
How long did you (or someone who helped you) need to travel to get your medicine
Did you get all the prescribed course(s) of medicines?
What was the MAIN reason you did NOT get the course(s) of medicines?
Did the provider prescribe any laboratory or diagnostic tests? For example, a bl
Were you able to get the test at the same place that it was prescribed?
How long did you (or someone who helped you) need to travel to get your test? (h
How long did you (or someone who helped you) need to travel to get your test? (m
Did you get all the tests you were prescribed?
What was the MAIN reason did you NOT get the tests?
Did the MAIN professional you saw explain the reasons for any treatment or actio
Were you given enough time to discuss your health or medical problem with a medi
How long did you spend with the MAIN medical professional you saw?
Were you involved as much as you wanted to be in decisions about your care and t
How clean was the place where you were treated?
Overall, how satisfied were you with the service you received in this place?
What was the outcome of this illness or treatment?
Stratum
Urban or rural
Sex
Age  in years
CensusUnitID
DwellingID
RegNo
UrbanOrRural
YarNo
QuartNo
UID
Food_consumption
Health_consumption
Total _Consumption
Total _Consumption_EqAdScale_08
Sample weight
Day of first visit
Month of first visit
Time of first visit
interviewed? (first visit)
If 'No', why not? (first visit)
Day of second visit
Month of second visit
Time of second visit
interviewed? (second visit)
If 'No', why not? (second visit)
Day of third visit
Month of third visit
Time of third visit
interviewed? (third visit)
If 'No', why not? (third visit)
Time Interview started
Time Interview finished
Interviewer: has the same (IHS) household been found?
Completeness of questionnaire, Section B, Expected number of completed sections
Completeness of questionnaire, Section B, Number of completed sections
Completeness of questionnaire, Section B, Complete?
Completeness of questionnaire, Section C, Expected number of completed sections
Completeness of questionnaire, Section C, Number of completed sections
Completeness of questionnaire, Section C, Complete?
Completeness of questionnaire, Section D, Expected number of completed sections
Completeness of questionnaire, Section D, Number of completed sections
Completeness of questionnaire, Section D, Complete?
Completeness of questionnaire, Section E, Expected number of completed sections
Completeness of questionnaire, Section E, Number of completed sections
Completeness of questionnaire, Section E, Complete?
Completeness of questionnaire, Section F, Expected number of completed sections
Completeness of questionnaire, Section F, Number of completed sections
Completeness of questionnaire, Section F, Complete?
Completeness of questionnaire, Section G, Expected number of completed sections
Completeness of questionnaire, Section G, Number of completed sections
Completeness of questionnaire, Section G, Complete?
Completeness of questionnaire, Section H, Expected number of completed sections
Completeness of questionnaire, Section H, Number of completed sections
Completeness of questionnaire, Section H, Complete?
Respondents S/N
What type of facility is that?
If someone in this family gets sick and needed to see a doctor, would they norma
Why not?
How many days per week is a doctor usually present at that facility?
How would you normally travel to this facility?
How long does it take to travel there in this way? (hours)
How long does it take to travel there in this way? (minutes)
Overall, how satisfied are you with the quality of services provided by this fac
How much do you trust this facility to give you and your household the health ca
In general, how affordable are the services provided by this facility?
Compared with three years ago, would you say that the quality of services offere
If you have a consultation with a doctor at this facility, would you normally ex
In the last 12 months, has anyone in your household been given advice and/or hel
In the last 12 months, has anyone in your household been given information by an
If you went for an ambulatory (outpatient) consultation at a general hospital, w
Would you say that, overall, the quality of health services available in Georgia
Do you know about the state programme for medical insurance for the population b
Do you know what benefits this insurance provides?
what this program provides (includes)?(first answer)
what this program provides (includes)?(second answer)
what this program provides (includes)?(third answer)
what this program provides (includes)?(fourth answer)
what this program provides (includes)?(fifth answer)
Are you or any member of your household beneficiary of universal health care pro
During the last 12 months did you or any member of your household have problems
If there had been any problem/misunderstanding, name it(first problem)
If there had been any problem/misunderstanding, name it(second problem)
If there had been any problem/misunderstanding, name it(third problem)
Whom did you address regarding the above problem/problems?
In addition to the Universal Health Care Program, do you know what kind of servi
Has anyone in your household given birth in the last two years (24 months)?
If yes, which family member(s) were pregnant? (first Person)
If yes, which family member(s) were pregnant? (second Person)
If yes, which family member(s) were pregnant? (third Person)
How many pre-natal appointments did you have during this last pregnancy? (first
How many pre-natal appointments did you have during this last pregnancy? (second
How many pre-natal appointments did you have during this last pregnancy? (third
How many times was your blood pressure taken by a medical practitioner during yo
(If yes) At which facilities was your blood pressure measured during this pregna
Did you have a urine test during your pregnancy? (first Person)
Did you have a urine test during your pregnancy? (second Person)
Did you have a urine test during your pregnancy? (third Person)
Were there any occasions within the last year when someone within the household
If yes, which family member was ill? (first episode)
If yes, which family member was ill? (second episode)
If yes, which family member was ill? (third episode)
What was the illness? (first episode)
What was the illness? (second episode)
What was the illness? (third episode)
Did a doctor or health professional say that they should be hospitalised? (first
Did a doctor or health professional say that they should be hospitalised? (secon
Did a doctor or health professional say that they should be hospitalised? (third
Why were they NOT hospitalised? (first episode)
Why were they NOT hospitalised? (second episode)
Why were they NOT hospitalised? (third episode)
Quintiles of Adult Equivalent HH Consumption