1 library AddressingSocialNeeds version '0.3.000'
2 
3 using QDM version '5.6'
4 
5 include MATGlobalCommonFunctionsQDM version '8.0.000' called Global
6 
7 codesystem "LOINC": 'urn:oid:2.16.840.1.113883.6.1' 
8 codesystem "ICD10CM": 'urn:oid:2.16.840.1.113883.6.90' 
9 codesystem "SNOMEDCT": 'urn:oid:2.16.840.1.113883.6.96' 
10 
11 valueset "ASN Screening Declined": 'urn:oid:2.16.840.1.113762.1.4.1170.10' 
12 valueset "Discharge To Acute Care Facility": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.87' 
13 valueset "Encounter Inpatient": 'urn:oid:2.16.840.1.113883.3.666.5.307' 
14 valueset "Ethnicity": 'urn:oid:2.16.840.1.114222.4.11.837' 
15 valueset "Food Insecurity Diagnosis": 'urn:oid:2.16.840.1.113762.1.4.1170.12' 
16 valueset "Intervention for Positive Food Insecurity Screen": 'urn:oid:2.16.840.1.113762.1.4.1170.19' 
17 valueset "Intervention for Positive Transportation Insecurity Screen": 'urn:oid:2.16.840.1.113762.1.4.1170.15' 
18 valueset "Intervention for Positive Utility Insecurity Screen": 'urn:oid:2.16.840.1.113762.1.4.1170.8' 
19 valueset "Left Against Medical Advice": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.308' 
20 valueset "ONC Administrative Sex": 'urn:oid:2.16.840.1.113762.1.4.1' 
21 valueset "Patient Declined": 'urn:oid:2.16.840.1.113883.3.526.3.1582' 
22 valueset "Patient Expired": 'urn:oid:2.16.840.1.113883.3.117.1.7.1.309' 
23 valueset "Payer Type": 'urn:oid:2.16.840.1.114222.4.11.3591' 
24 valueset "Race": 'urn:oid:2.16.840.1.114222.4.11.836' 
25 valueset "Transportation Insecurity Diagnosis": 'urn:oid:2.16.840.1.113762.1.4.1170.11' 
26 valueset "Utility Insecurity Diagnosis": 'urn:oid:2.16.840.1.113762.1.4.1170.9' 
27 
28 code "Access to transportation/mobility status [CUBS]": '89569-8' from "LOINC" display 'Access to transportation/mobility status [CUBS]'
29 code "Almost every month": 'LA30970-0' from "LOINC" display 'Almost every month'
30 code "Already shut off": 'LA32002-0' from "LOINC" display 'Already shut off'
31 code "Birth date": '21112-8' from "LOINC" display 'Birth date'
32 code "Delayed medical care due to distance or lack of transportation": '99594-4' from "LOINC" display 'Delayed medical care due to distance or lack of transportation'
33 code "DK": 'LA14226-7' from "LOINC" display 'DK'
34 code "DK or Refused": 'LA30968-4' from "LOINC" display 'DK or Refused'
35 code "Do you have trouble finding or paying for transportation [WellRx]": '93671-6' from "LOINC" display 'Do you have trouble finding or paying for transportation [WellRx]'
36 code "Do you have trouble paying for your gas or electricity bills [WellRx]": '93670-8' from "LOINC" display 'Do you have trouble paying for your gas or electricity bills [WellRx]'
37 code "Dont know/refused": 'LA15775-2' from "LOINC" display 'Dont know/refused'
38 code "Enough but not always the kinds of food we want": 'LA30965-0' from "LOINC" display 'Enough but not always the kinds of food we want'
39 code "Enough of the kinds of food we want to eat": 'LA30964-3' from "LOINC" display 'Enough of the kinds of food we want to eat'
40 code "Food": 'LA30125-1' from "LOINC" display 'Food'
41 code "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living": '93030-5' from "LOINC" display 'Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living'
42 code "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living [CMS Assessment]": '101351-5' from "LOINC" display 'Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living [CMS Assessment]'
43 code "Has the electric, gas, oil, or water company threatened to shut off services in your home in past 12 months": '96779-4' from "LOINC" display 'Has the electric, gas, oil, or water company threatened to shut off services in your home in past 12 months'
44 code "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]": '93031-3' from "LOINC" display 'Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]'
45 code "I choose not to answer this question": 'LA30122-8' from "LOINC" display 'I choose not to answer this question'
46 code "I have no access to transportation, public or private; may have car that is inoperable": 'LA29234-4' from "LOINC" display 'I have no access to transportation, public or private; may have car that is inoperable'
47 code "In the last 12 months, did any of the children ever not eat for a whole day because there wasnt enough money for food [U.S. FSS]": '95262-2' from "LOINC" display 'In the last 12 months, did any of the children ever not eat for a whole day because there wasnt enough money for food [U.S. FSS]'
48 code "In the last 12 months, did any of the children ever skip meals because there wasnt enough money for food [U.S. FSS]": '95259-8' from "LOINC" display 'In the last 12 months, did any of the children ever skip meals because there wasnt enough money for food [U.S. FSS]'
49 code "In the last 12 months, did you ever cut the size of any of the childrens meals or skip meals because there wasnt enough money for food [U.S. FSS]": '95265-5' from "LOINC" display 'In the last 12 months, did you ever cut the size of any of the childrens meals or skip meals because there wasnt enough money for food [U.S. FSS]'
50 code "In the last 12 months, did you ever cut the size of your meals or skip meals because there wasnt enough money for food [U.S. FSS]": '95249-9' from "LOINC" display 'In the last 12 months, did you ever cut the size of your meals or skip meals because there wasnt enough money for food [U.S. FSS]'
51 code "In the last 12 months, did you ever eat less than you felt you should because there wasnt enough money for food [U.S. FSS]": '95251-5' from "LOINC" display 'In the last 12 months, did you ever eat less than you felt you should because there wasnt enough money for food [U.S. FSS]'
52 code "In the last 12 months, did you ever not eat for a whole day because there wasnt enough money for food [U.S. FSS]": '95254-9' from "LOINC" display 'In the last 12 months, did you ever not eat for a whole day because there wasnt enough money for food [U.S. FSS]'
53 code "In the last 12 months, did you lose weight because there wasnt enough money for food [U.S. FSS]": '95253-1' from "LOINC" display 'In the last 12 months, did you lose weight because there wasnt enough money for food [U.S. FSS]'
54 code "In the last 12 months, how often did any of the children skip meals because there wasnt enough money for food [U.S. FSS]": '95260-6' from "LOINC" display 'In the last 12 months, how often did any of the children skip meals because there wasnt enough money for food [U.S. FSS]'
55 code "In the last 12 months, how often did you cut the size of your meals or skip meals because there wasnt enough money for food [U.S. FSS]": '95250-7' from "LOINC" display 'In the last 12 months, how often did you cut the size of your meals or skip meals because there wasnt enough money for food [U.S. FSS]'
56 code "In the last 12 months, how often did you not eat for a whole day because there wasnt enough money for food [U.S. FSS]": '95255-6' from "LOINC" display 'In the last 12 months, how often did you not eat for a whole day because there wasnt enough money for food [U.S. FSS]'
57 code "In the last 12 months, I couldnt feed my children a balanced meal, because I couldnt afford that [U.S. FSS]": '95257-2' from "LOINC" display 'In the last 12 months, I couldnt feed my children a balanced meal, because I couldnt afford that [U.S. FSS]'
58 code "In the last 12 months, I relied on only a few kinds of low-cost food to feed my children because I was running out of money to buy food [U.S. FSS]": '95256-4' from "LOINC" display 'In the last 12 months, I relied on only a few kinds of low-cost food to feed my children because I was running out of money to buy food [U.S. FSS]'
59 code "In the last 12 months, my children were not eating enough because I just couldnt afford enough food [U.S. FSS]": '95258-0' from "LOINC" display 'In the last 12 months, my children were not eating enough because I just couldnt afford enough food [U.S. FSS]'
60 code "In the last 12 months, we couldnt afford to eat balanced meals [U.S. FSS]": '95248-1' from "LOINC" display 'In the last 12 months, we couldnt afford to eat balanced meals [U.S. FSS]'
61 code "In the last 12 months, were the children ever hungry but you just couldnt afford more food [U.S. FSS]": '95261-4' from "LOINC" display 'In the last 12 months, were the children ever hungry but you just couldnt afford more food [U.S. FSS]'
62 code "In the last 12 months, were you ever hungry but didnt eat because there wasnt enough money for food [U.S. FSS]": '95252-3' from "LOINC" display 'In the last 12 months, were you ever hungry but didnt eat because there wasnt enough money for food [U.S. FSS]'
63 code "Material hardship": 'Z59.87' from "ICD10CM" display 'Material hardship'
64 code "My transportation is available and reliable, but limited and/or inconvenient; drivers are licensed and minimally insured": 'LA29232-8' from "LOINC" display 'My transportation is available and reliable, but limited and/or inconvenient; drivers are licensed and minimally insured'
65 code "My transportation is available, but unreliable, unpredictable, unaffordable; may have car but no insurance, license, etc.": 'LA29233-6' from "LOINC" display 'My transportation is available, but unreliable, unpredictable, unaffordable; may have car but no insurance, license, etc.'
66 code "My transportation is generally accessible to meet basic travel needs": 'LA29231-0' from "LOINC" display 'My transportation is generally accessible to meet basic travel needs'
67 code "My transportation is readily available, affordable, and car is adequately insured": 'LA29230-2' from "LOINC" display 'My transportation is readily available, affordable, and car is adequately insured'
68 code "Never true": 'LA28398-8' from "LOINC" display 'Never true'
69 code "No": 'LA32-8' from "LOINC" display 'No'
70 code "No (qualifier value)": '373067005' from "SNOMEDCT" display 'No (qualifier value)'
71 code "Often not enough to eat": 'LA30967-6' from "LOINC" display 'Often not enough to eat'
72 code "Often true": 'LA28397-0' from "LOINC" display 'Often true'
73 code "Only 1 or 2 months": 'LA30972-6' from "LOINC" display 'Only 1 or 2 months'
74 code "Resident declines to respond": 'LA33608-3' from "LOINC" display 'Resident declines to respond'
75 code "Resident unable to respond": 'LA30435-4' from "LOINC" display 'Resident unable to respond'
76 code "Some months but not every month": 'LA30971-8' from "LOINC" display 'Some months but not every month'
77 code "Sometimes not enough to eat": 'LA30966-8' from "LOINC" display 'Sometimes not enough to eat'
78 code "Sometimes true": 'LA6729-3' from "LOINC" display 'Sometimes true'
79 code "Utilities": 'LA30124-4' from "LOINC" display 'Utilities'
80 code "Went without health care due to lack of transportation in last 12 months": '99553-0' from "LOINC" display 'Went without health care due to lack of transportation in last 12 months'
81 code "Which of these statements best describes the food eaten in your household in the last 12 months [U.S. FSS]": '95247-3' from "LOINC" display 'Which of these statements best describes the food eaten in your household in the last 12 months [U.S. FSS]'
82 code "Within the past 12 months the food we bought just didnt last and we didnt have money to get more [U.S. FSS]": '88123-5' from "LOINC" display 'Within the past 12 months the food we bought just didnt last and we didnt have money to get more [U.S. FSS]'
83 code "Within the past 12 months the food we bought just didnt last and we didnt have money to get more Caregiver [U.S. FSS]": '95399-2' from "LOINC" display 'Within the past 12 months the food we bought just didnt last and we didnt have money to get more Caregiver [U.S. FSS]'
84 code "Within the past 12 months we worried whether our food would run out before we got money to buy more [U.S. FSS]": '88122-7' from "LOINC" display 'Within the past 12 months we worried whether our food would run out before we got money to buy more [U.S. FSS]'
85 code "Within the past 12 months we worried whether our food would run out before we got money to buy more Caregiver [U.S. FSS]": '95400-8' from "LOINC" display 'Within the past 12 months we worried whether our food would run out before we got money to buy more Caregiver [U.S. FSS]'
86 code "Yes": 'LA33-6' from "LOINC" display 'Yes'
87 code "Yes, it has kept me from medical appointments or from getting my medications": 'LA30133-5' from "LOINC" display 'Yes, it has kept me from medical appointments or from getting my medications'
88 code "Yes, it has kept me from medical appointments or getting medications": 'LA33093-8' from "LOINC" display 'Yes, it has kept me from medical appointments or getting medications'
89 code "Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need": 'LA30134-3' from "LOINC" display 'Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need'
90 
91 parameter "Measurement Period" Interval<DateTime>
92 
93 context Patient
94 
95 define "Denominator Exclusion":
96   "Inpatient Encounter" Hospitalization
97     where Hospitalization.dischargeDisposition in "Discharge To Acute Care Facility"
98       or Hospitalization.dischargeDisposition in "Left Against Medical Advice"
99       or Hospitalization.dischargeDisposition in "Patient Expired"
100 
101 define "Food Insecurity Assessment Performed":
102   ( ["Assessment, Performed": "In the last 12 months, did any of the children ever not eat for a whole day because there wasnt enough money for food [U.S. FSS]"]
103       union ["Assessment, Performed": "In the last 12 months, did any of the children ever skip meals because there wasnt enough money for food [U.S. FSS]"]
104       union ["Assessment, Performed": "In the last 12 months, did you ever cut the size of any of the childrens meals or skip meals because there wasnt enough money for food [U.S. FSS]"]
105       union ["Assessment, Performed": "In the last 12 months, did you ever cut the size of your meals or skip meals because there wasnt enough money for food [U.S. FSS]"]
106       union ["Assessment, Performed": "In the last 12 months, did you ever eat less than you felt you should because there wasnt enough money for food [U.S. FSS]"]
107       union ["Assessment, Performed": "In the last 12 months, did you ever not eat for a whole day because there wasnt enough money for food [U.S. FSS]"]
108       union ["Assessment, Performed": "In the last 12 months, did you lose weight because there wasnt enough money for food [U.S. FSS]"]
109       union ["Assessment, Performed": "In the last 12 months, how often did any of the children skip meals because there wasnt enough money for food [U.S. FSS]"]
110       union ["Assessment, Performed": "In the last 12 months, how often did you cut the size of your meals or skip meals because there wasnt enough money for food [U.S. FSS]"]
111       union ["Assessment, Performed": "In the last 12 months, how often did you not eat for a whole day because there wasnt enough money for food [U.S. FSS]"]
112       union ["Assessment, Performed": "In the last 12 months, I couldnt feed my children a balanced meal, because I couldnt afford that [U.S. FSS]"]
113       union ["Assessment, Performed": "In the last 12 months, I relied on only a few kinds of low-cost food to feed my children because I was running out of money to buy food [U.S. FSS]"]
114       union ["Assessment, Performed": "In the last 12 months, my children were not eating enough because I just couldnt afford enough food [U.S. FSS]"]
115       union ["Assessment, Performed": "In the last 12 months, we couldnt afford to eat balanced meals [U.S. FSS]"]
116       union ["Assessment, Performed": "In the last 12 months, were the children ever hungry but you just couldnt afford more food [U.S. FSS]"]
117       union ["Assessment, Performed": "In the last 12 months, were you ever hungry but didnt eat because there wasnt enough money for food [U.S. FSS]"]
118       union ["Assessment, Performed": "Which of these statements best describes the food eaten in your household in the last 12 months [U.S. FSS]"]
119       union ["Assessment, Performed": "Within the past 12 months the food we bought just didnt last and we didnt have money to get more Caregiver [U.S. FSS]"]
120       union ["Assessment, Performed": "Within the past 12 months we worried whether our food would run out before we got money to buy more [U.S. FSS]"]
121       union ["Assessment, Performed": "Within the past 12 months we worried whether our food would run out before we got money to buy more Caregiver [U.S. FSS]"]
122       union ["Assessment, Performed": "Within the past 12 months the food we bought just didnt last and we didnt have money to get more [U.S. FSS]"]
123   )
124 
125 define "Food Insecurity Follow Up Intervention Order or Performed Declined":
126   "Inpatient Encounter" Hospitalization
127     with ( ["Intervention, Not Performed": "Intervention for Positive Food Insecurity Screen"]
128       union ["Intervention, Not Ordered": "Intervention for Positive Food Insecurity Screen"] ) NoFoodInsecurityIntervention
129       such that NoFoodInsecurityIntervention.authorDatetime during Hospitalization.relevantPeriod
130         and NoFoodInsecurityIntervention.negationRationale in "ASN Screening Declined"
131 
132 define "Food Insecurity Follow-Up Intervention Ordered or Performed":
133   "Inpatient Encounter" Hospitalization
134     with ( ["Intervention, Performed": "Intervention for Positive Food Insecurity Screen"]
135       union ["Intervention, Order": "Intervention for Positive Food Insecurity Screen"] ) FoodInsecurityIntervention
136       such that ( Global."NormalizeInterval" ( FoodInsecurityIntervention.relevantDatetime, FoodInsecurityIntervention.relevantPeriod ) starts during Hospitalization.relevantPeriod )
137         or FoodInsecurityIntervention.authorDatetime during Hospitalization.relevantPeriod
138 
139 define "Food Insecurity ICD10CM Diagnosis":
140   "Inpatient Encounter" Hospitalization
141     with ["Diagnosis": "Food Insecurity Diagnosis"] FoodDiagnosis
142       such that FoodDiagnosis.prevalencePeriod starts during Hospitalization.relevantPeriod
143         or FoodDiagnosis.authorDatetime during Hospitalization.relevantPeriod
144 
145 define "Food Insecurity Negative Screen":
146   "Inpatient Encounter" Hospitalization
147     with "Food Insecurity Assessment Performed" FoodScreen
148       such that ( ( FoodScreen.result ~ "No" )
149           or ( FoodScreen.result ~ "Never true" )
150           or ( FoodScreen.result ~ "Dont know/refused" )
151           or ( FoodScreen.result ~ "DK or Refused" )
152           or ( FoodScreen.result ~ "Enough of the kinds of food we want to eat" )
153           or ( FoodScreen.result ~ "Enough but not always the kinds of food we want" )
154           or ( FoodScreen.result ~ "Never true" )
155           or ( FoodScreen.result ~ "DK" )
156           or ( FoodScreen.result ~ "Only 1 or 2 months" )
157       )
158         and Global."NormalizeInterval" ( FoodScreen.relevantDatetime, FoodScreen.relevantPeriod ) during Hospitalization.relevantPeriod
159 
160 define "Food Insecurity Numerator 1: No Food Insecurity Screen And No Food Insecurity ICD-10-CM Diagnosis":
161   /*Food Insecurity Numerator 1: No Food Insecurity Screen And No Food Insecurity ICD-10-CM Diagnosis*/
162   
163   "Inpatient Encounter" Hospitalization
164     where exists ( "Food Insecurity Screen No Result"
165         union "No Food Insecurity Screen"
166     )
167       and not exists "Food Insecurity ICD10CM Diagnosis"
168       and not exists "Food Insecurity Screen Declined by Patient"
169 
170 define "Food Insecurity Positive Screen":
171   "Inpatient Encounter" Hospitalization
172     with "Food Insecurity Assessment Performed" FoodScreen
173       such that ( ( FoodScreen.result ~ "Yes" )
174           or ( FoodScreen.result ~ "Often true" )
175           or ( FoodScreen.result ~ "Sometimes true" )
176           or ( FoodScreen.result ~ "Almost every month" )
177           or ( FoodScreen.result ~ "Some months but not every month" )
178           or ( FoodScreen.result ~ "Sometimes not enough to eat" )
179           or ( FoodScreen.result ~ "Often not enough to eat" )
180       )
181         and Global."NormalizeInterval" ( FoodScreen.relevantDatetime, FoodScreen.relevantPeriod ) during Hospitalization.relevantPeriod
182 
183 define "Food Insecurity Screen Declined":
184   "Inpatient Encounter" Hospitalization
185     with "No Food Insecurity Assessment Performed" FoodScreen
186       such that FoodScreen.authorDatetime during Hospitalization.relevantPeriod
187         and FoodScreen.negationRationale in "ASN Screening Declined"
188 
189 define "Food Insecurity Screen Declined by Patient":
190   "Inpatient Encounter" Hospitalization
191     where exists "Food Insecurity Screen Declined"
192       and exists "No Food Insecurity Screen"
193       and not exists "Food Insecurity ICD10CM Diagnosis"
194 
195 define "Food Insecurity Screen No Result":
196   "Inpatient Encounter" Hospitalization
197     with "Food Insecurity Assessment Performed" FoodScreen
198       such that Global."NormalizeInterval" ( FoodScreen.relevantDatetime, FoodScreen.relevantPeriod ) during Hospitalization.relevantPeriod
199         and FoodScreen.result is null
200 
201 define "Initial Population":
202   "Inpatient Encounter"
203 
204 define "Inpatient Encounter":
205   ["Encounter, Performed": "Encounter Inpatient"] EncounterInpatient
206     where EncounterInpatient.relevantPeriod ends during day of "Measurement Period"
207 
208 define "No Food Insecurity Assessment Performed":
209   ( ["Assessment, Not Performed": "In the last 12 months, did any of the children ever not eat for a whole day because there wasnt enough money for food [U.S. FSS]"]
210       union ["Assessment, Not Performed": "In the last 12 months, did any of the children ever skip meals because there wasnt enough money for food [U.S. FSS]"]
211       union ["Assessment, Not Performed": "In the last 12 months, did you ever cut the size of any of the childrens meals or skip meals because there wasnt enough money for food [U.S. FSS]"]
212       union ["Assessment, Not Performed": "In the last 12 months, did you ever cut the size of your meals or skip meals because there wasnt enough money for food [U.S. FSS]"]
213       union ["Assessment, Not Performed": "In the last 12 months, did you ever eat less than you felt you should because there wasnt enough money for food [U.S. FSS]"]
214       union ["Assessment, Not Performed": "In the last 12 months, did you ever not eat for a whole day because there wasnt enough money for food [U.S. FSS]"]
215       union ["Assessment, Not Performed": "In the last 12 months, did you lose weight because there wasnt enough money for food [U.S. FSS]"]
216       union ["Assessment, Not Performed": "In the last 12 months, how often did any of the children skip meals because there wasnt enough money for food [U.S. FSS]"]
217       union ["Assessment, Not Performed": "In the last 12 months, how often did you cut the size of your meals or skip meals because there wasnt enough money for food [U.S. FSS]"]
218       union ["Assessment, Not Performed": "In the last 12 months, how often did you not eat for a whole day because there wasnt enough money for food [U.S. FSS]"]
219       union ["Assessment, Not Performed": "In the last 12 months, I couldnt feed my children a balanced meal, because I couldnt afford that [U.S. FSS]"]
220       union ["Assessment, Not Performed": "In the last 12 months, I relied on only a few kinds of low-cost food to feed my children because I was running out of money to buy food [U.S. FSS]"]
221       union ["Assessment, Not Performed": "In the last 12 months, my children were not eating enough because I just couldnt afford enough food [U.S. FSS]"]
222       union ["Assessment, Not Performed": "In the last 12 months, we couldnt afford to eat balanced meals [U.S. FSS]"]
223       union ["Assessment, Not Performed": "In the last 12 months, were the children ever hungry but you just couldnt afford more food [U.S. FSS]"]
224       union ["Assessment, Not Performed": "In the last 12 months, were you ever hungry but didnt eat because there wasnt enough money for food [U.S. FSS]"]
225       union ["Assessment, Not Performed": "Which of these statements best describes the food eaten in your household in the last 12 months [U.S. FSS]"]
226       union ["Assessment, Not Performed": "Within the past 12 months the food we bought just didnt last and we didnt have money to get more Caregiver [U.S. FSS]"]
227       union ["Assessment, Not Performed": "Within the past 12 months we worried whether our food would run out before we got money to buy more [U.S. FSS]"]
228       union ["Assessment, Not Performed": "Within the past 12 months we worried whether our food would run out before we got money to buy more Caregiver [U.S. FSS]"]
229       union ["Assessment, Not Performed": "Within the past 12 months the food we bought just didnt last and we didnt have money to get more [U.S. FSS]"]
230   )
231 
232 define "No Food Insecurity Screen":
233   "Inpatient Encounter" Hospitalization
234     without "Food Insecurity Assessment Performed" WithoutFoodScreen
235       such that Global."NormalizeInterval" ( WithoutFoodScreen.relevantDatetime, WithoutFoodScreen.relevantPeriod ) during Hospitalization.relevantPeriod
236 
237 define "No Utility Insecurity Screen":
238   "Inpatient Encounter" Hospitalization
239     without "Utility Insecurity Assessment Performed" WithoutUtilityScreen
240       such that Global."NormalizeInterval" ( WithoutUtilityScreen.relevantDatetime, WithoutUtilityScreen.relevantPeriod ) during Hospitalization.relevantPeriod
241 
242 define "SDE Ethnicity":
243   ["Patient Characteristic Ethnicity": "Ethnicity"]
244 
245 define "SDE Payer":
246   ["Patient Characteristic Payer": "Payer Type"]
247 
248 define "SDE Race":
249   ["Patient Characteristic Race": "Race"]
250 
251 define "SDE Sex":
252   ["Patient Characteristic Sex": "ONC Administrative Sex"]
253 
254 define "Transportation Insecurity Assessment Not Performed":
255   ( ["Assessment, Not Performed": "Do you have trouble finding or paying for transportation [WellRx]"]
256       union ["Assessment, Not Performed": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"]
257       union ["Assessment, Not Performed": "Delayed medical care due to distance or lack of transportation"]
258       union ["Assessment, Not Performed": "Went without health care due to lack of transportation in last 12 months"]
259       union ["Assessment, Not Performed": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living [CMS Assessment]"]
260   )
261 
262 define "Transportation Insecurity Assessment Performed":
263   ( ["Assessment, Performed": "Do you have trouble finding or paying for transportation [WellRx]"]
264       union ["Assessment, Performed": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"]
265       union ["Assessment, Performed": "Delayed medical care due to distance or lack of transportation"]
266       union ["Assessment, Performed": "Went without health care due to lack of transportation in last 12 months"]
267       union ["Assessment, Performed": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living [CMS Assessment]"]
268   )
269 
270 define "Transportation Insecurity Follow-Up Intervention Ordered or Performed":
271   "Inpatient Encounter" Hospitalization
272     with ( ["Intervention, Performed": "Intervention for Positive Transportation Insecurity Screen"]
273       union ["Intervention, Order": "Intervention for Positive Transportation Insecurity Screen"] ) TransportInsecurityIntervention
274       such that ( Global."NormalizeInterval" ( TransportInsecurityIntervention.relevantDatetime, TransportInsecurityIntervention.relevantPeriod ) starts during Hospitalization.relevantPeriod )
275         or TransportInsecurityIntervention.authorDatetime during Hospitalization.relevantPeriod
276 
277 define "Transportation Insecurity ICD10CM Diagnosis":
278   "Inpatient Encounter" Hospitalization
279     with ["Diagnosis": "Transportation Insecurity Diagnosis"] TransportDiagnosis
280       such that TransportDiagnosis.prevalencePeriod starts during Hospitalization.relevantPeriod
281         or TransportDiagnosis.authorDatetime during Hospitalization.relevantPeriod
282 
283 define "Transportation Insecurity Negative Screen":
284   "Inpatient Encounter" Hospitalization
285     with "Transportation Insecurity Assessment Performed" TransportScreen
286       such that ( TransportScreen.result ~ "No" )
287         and Global."NormalizeInterval" ( TransportScreen.relevantDatetime, TransportScreen.relevantPeriod ) during Hospitalization.relevantPeriod
288 
289 define "Transportation Insecurity Positive Screen":
290   "Inpatient Encounter" Hospitalization
291     with "Transportation Insecurity Assessment Performed" TransportScreen
292       such that ( ( TransportScreen.result ~ "Yes" )
293           or ( TransportScreen.result ~ "Yes, it has kept me from medical appointments or from getting my medications" )
294           or ( TransportScreen.result ~ "Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need" )
295       )
296         and Global."NormalizeInterval" ( TransportScreen.relevantDatetime, TransportScreen.relevantPeriod ) during Hospitalization.relevantPeriod
297 
298 define "Transportation Insecurity PRAPARE Decline to Answer":
299   "Inpatient Encounter" Hospitalization
300     with ( ["Assessment, Performed": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"] ) PRAPARETransportScreen
301       such that Global."NormalizeInterval" ( PRAPARETransportScreen.relevantDatetime, PRAPARETransportScreen.relevantPeriod ) during Hospitalization.relevantPeriod
302         and PRAPARETransportScreen.result ~ "I choose not to answer this question"
303 
304 define "Transportation Insecurity Screen Declined":
305   "Inpatient Encounter" Hospitalization
306     with "Transportation Insecurity Assessment Not Performed" TransportScreen
307       such that TransportScreen.authorDatetime during Hospitalization.relevantPeriod
308         and TransportScreen.negationRationale in "ASN Screening Declined"
309 
310 define "Transportation Insecurity Screen Declined by Patient":
311   "Inpatient Encounter" Hospitalization
312     where exists "Transportation Insecurity Screen Declined"
313       and exists "No Transportation Insecurity Screen"
314       and not exists "Transportation Insecurity ICD10CM Diagnosis"
315 
316 define "Transportation Insecurity Screen No Result":
317   "Inpatient Encounter" Hospitalization
318     with "Transportation Insecurity Assessment Performed" TransportScreen
319       such that Global."NormalizeInterval" ( TransportScreen.relevantDatetime, TransportScreen.relevantPeriod ) during Hospitalization.relevantPeriod
320         and TransportScreen.result is null
321 
322 define "Utility Insecurity Assessment Not Performed":
323   ( ["Assessment, Not Performed": "Do you have trouble paying for your gas or electricity bills [WellRx]"]
324       union ["Assessment, Not Performed": "Has the electric, gas, oil, or water company threatened to shut off services in your home in past 12 months"]
325       union ["Assessment, Not Performed": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"]
326   )
327 
328 define "Utility Insecurity Assessment Performed":
329   ( ["Assessment, Performed": "Do you have trouble paying for your gas or electricity bills [WellRx]"]
330       union ["Assessment, Performed": "Has the electric, gas, oil, or water company threatened to shut off services in your home in past 12 months"]
331       union ["Assessment, Performed": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"]
332   )
333 
334 define "Utility Insecurity ICD10CM Diagnosis":
335   "Inpatient Encounter" Hospitalization
336     with ["Diagnosis": "Utility Insecurity Diagnosis"] UtilityDiagnosis
337       such that UtilityDiagnosis.prevalencePeriod starts during Hospitalization.relevantPeriod
338         or UtilityDiagnosis.authorDatetime during Hospitalization.relevantPeriod
339 
340 define "Utility Insecurity Negative Screen":
341   "Inpatient Encounter" Hospitalization
342     with "Utility Insecurity Assessment Performed" UtilityScreen
343       such that ( UtilityScreen.result ~ "No" )
344         and Global."NormalizeInterval" ( UtilityScreen.relevantDatetime, UtilityScreen.relevantPeriod ) during Hospitalization.relevantPeriod
345 
346 define "Utility Insecurity Overall Domain Score: Utility Insecurity Screen Negative or Screen Positive With Intervention (Sum of Numerators 4 and 5)":
347   /*Utility Insecurity Overall Domain Score: Utility Insecurity Screen Negative or Screen Positive With Intervention (Sum of Numerators 4 and 5)*/
348   ( "Inpatient Encounter" Hospitalization
349       where exists "Utility Insecurity Negative Screen"
350         and not exists "Utility Insecurity ICD10CM Diagnosis"
351   )
352     union ( "Inpatient Encounter" Hospitalization
353         where exists ( "Utility Insecurity ICD10CM Diagnosis"
354             union "Utility Insecurity Positive Screen"
355         )
356           and exists "Utility Insecurity Follow-Up Intervention Ordered or Performed"
357     )
358 
359 define "Utility Insecurity Positive Screen":
360   "Inpatient Encounter" Hospitalization
361     with "Utility Insecurity Assessment Performed" UtilityScreen
362       such that ( ( UtilityScreen.result ~ "Yes" )
363           or ( UtilityScreen.result ~ "Already shut off" )
364           or ( UtilityScreen.result ~ "Utilities" )
365       )
366         and Global."NormalizeInterval" ( UtilityScreen.relevantDatetime, UtilityScreen.relevantPeriod ) during Hospitalization.relevantPeriod
367 
368 define "Utility Insecurity PRAPARE Decline to Answer":
369   "Inpatient Encounter" Hospitalization
370     with ( ["Assessment, Performed": "Have you or any family members you live with been unable to get any of the following when it was really needed in past 1 year [PRAPARE]"] ) PRAPAREUtilityScreen
371       such that Global."NormalizeInterval" ( PRAPAREUtilityScreen.relevantDatetime, PRAPAREUtilityScreen.relevantPeriod ) during Hospitalization.relevantPeriod
372         and PRAPAREUtilityScreen.result ~ "I choose not to answer this question"
373 
374 define "Utility Insecurity Screen Declined":
375   "Inpatient Encounter" Hospitalization
376     with "Utility Insecurity Assessment Not Performed" UtilityScreen
377       such that UtilityScreen.authorDatetime during Hospitalization.relevantPeriod
378         and UtilityScreen.negationRationale in "ASN Screening Declined"
379 
380 define "Utility Insecurity Screen Declined by Patient":
381   "Inpatient Encounter" Hospitalization
382     where exists "Utility Insecurity Screen Declined"
383       and exists "No Utility Insecurity Screen"
384       and not exists "Utility Insecurity ICD10CM Diagnosis"
385 
386 define "Utility Insecurity Screen No Result":
387   "Inpatient Encounter" Hospitalization
388     with "Utility Insecurity Assessment Performed" UtilityScreen
389       such that Global."NormalizeInterval" ( UtilityScreen.relevantDatetime, UtilityScreen.relevantPeriod ) during Hospitalization.relevantPeriod
390         and UtilityScreen.result is null
391 
392 define "No Transportation Insecurity Screen":
393   "Inpatient Encounter" Hospitalization
394     without ( ["Assessment, Performed": "Do you have trouble finding or paying for transportation [WellRx]"]
395       union ["Assessment, Performed": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living"]
396       union ["Assessment, Performed": "Delayed medical care due to distance or lack of transportation"]
397       union ["Assessment, Performed": "Went without health care due to lack of transportation in last 12 months"]
398       union ["Assessment, Performed": "Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living [CMS Assessment]"] ) WithoutTransportScreen
399       such that Global."NormalizeInterval" ( WithoutTransportScreen.relevantDatetime, WithoutTransportScreen.relevantPeriod ) during Hospitalization.relevantPeriod
400 
401 define "Transportation Insecurity Numerator 1: No Transportation Insecurity Screen And No Transportation Insecurity ICD-10-CM Diagnosis":
402   /*Transportation Insecurity Numerator 1: No Transportation Insecurity Screen And No Transportation Insecurity ICD-10-CM Diagnosis*/
403   
404   "Inpatient Encounter" Hospitalization
405     where exists ( "Transportation Insecurity Screen No Result"
406         union "No Transportation Insecurity Screen"
407     )
408       and not exists "Transportation Insecurity ICD10CM Diagnosis"
409       and not exists "Transportation Insecurity PRAPARE Decline to Answer"
410       and not exists "Transportation Insecurity Screen Declined by Patient"
411 
412 define "Food Insecurity Numerator 2: Food Insecurity Screen Declined":
413   /*Food Insecurity Numerator 2: Food Insecurity Screen Declined*/
414   
415   "Inpatient Encounter" Hospitalization
416     where exists "Food Insecurity Screen Declined by Patient"
417 
418 define "Utility Insecurity Numerator 2: Utility Insecurity Screen Declined":
419   /*Utility Insecurity Numerator 2: Utility Insecurity Screen Declined*/
420   
421   "Inpatient Encounter" Hospitalization
422     where exists "Utility Insecurity PRAPARE Decline to Answer"
423       or exists "Utility Insecurity Screen Declined by Patient"
424 
425 define "Food Insecurity Numerator 3: Food Insecurity Positive With No Intervention":
426   /*Food Insecurity Numerator 3: Food Insecurity Positive With No Intervention*/
427    "Inpatient Encounter" Hospitalization
428     where exists ( "Food Insecurity Positive Screen"
429         union "Food Insecurity ICD10CM Diagnosis"
430     )
431       and not exists "Food Insecurity Follow-Up Intervention Ordered or Performed"
432 
433 define "Transportation Insecurity Numerator 2: Transportation Insecurity Screen Declined":
434   /*Transportation Insecurity Numerator 2: Transportation Insecurity Screen Declined*/
435   "Inpatient Encounter" Hospitalization
436     where exists "Transportation Insecurity PRAPARE Decline to Answer"
437       or exists "Transportation Insecurity Screen Declined by Patient"
438 
439 define "Transportation Insecurity Overall Domain Score: Transportation Insecurity Screen Negative or Screen Positive With Intervention (Sum of Numerators 4 and 5)":
440   /*Transportation Insecurity Overall Domain Score: Transportation Insecurity Screen Negative or Screen Positive With Intervention (Sum of Numerators 4 and 5)*/
441   ( "Inpatient Encounter" Hospitalization
442       where exists "Transportation Insecurity Negative Screen"
443         and not exists "Transportation Insecurity ICD10CM Diagnosis"
444   )
445     union ( "Inpatient Encounter" Hospitalization
446         where exists ( "Transportation Insecurity ICD10CM Diagnosis"
447             union "Transportation Insecurity Positive Screen"
448         )
449           and exists "Transportation Insecurity Follow-Up Intervention Ordered or Performed"
450     )
451 
452 define "SDE Birth Date":
453   ["Patient Characteristic Birthdate": "Birth date"]
454 
455 define "Food Insecurity Overall Domain Score: Food Insecurity Screen Negative or Screen Positive With Intervention (Sum of Numerators 4 and 5)":
456   /*Food Insecurity Overall Domain Score: Food Insecurity Screen Negative or Screen Positive With Intervention (Sum of Numerators 4 and 5)*/
457     ( "Inpatient Encounter" Hospitalization
458       where exists "Food Insecurity Negative Screen"
459         and not exists "Food Insecurity ICD10CM Diagnosis"
460   )
461     union ( "Inpatient Encounter" Hospitalization
462         where exists ( "Food Insecurity ICD10CM Diagnosis"
463             union "Food Insecurity Positive Screen"
464         )
465           and exists "Food Insecurity Follow-Up Intervention Ordered or Performed"
466     )
467 
468 define "Denominator":
469   "Initial Population"
470 
471 define "Transportation Insecurity Numerator 3: Transportation Insecurity Positive With No Intervention":
472   /*Transportation Insecurity Numerator 3: Transportation Insecurity Positive With No Intervention*/
473   
474   "Inpatient Encounter" Hospitalization
475     where exists ( "Transportation Insecurity Positive Screen"
476         union "Transportation Insecurity ICD10CM Diagnosis"
477     )
478       and not exists "Transportation Insecurity Follow-Up Intervention Ordered or Performed"
479 
480 define "Utility Insecurity Numerator 3: Utility Insecurity Positive With No Intervention":
481   /*Utility Insecurity Numerator 3: Utility Insecurity Positive With No Intervention*/
482   
483   "Inpatient Encounter" Hospitalization
484     where exists ( "Utility Insecurity Positive Screen"
485         union "Utility Insecurity ICD10CM Diagnosis"
486     )
487       and not exists "Utility Insecurity Follow-Up Intervention Ordered or Performed"
488 
489 define "Food Insecurity Numerator 4: Food Insecurity Screen Positive With Intervention Performed":
490   /*Food Insecurity Numerator 4: Food Insecurity Screen Positive With Intervention Performed*/
491   
492   "Inpatient Encounter" Hospitalization
493     where exists ( "Food Insecurity ICD10CM Diagnosis"
494         union "Food Insecurity Positive Screen"
495     )
496       and exists "Food Insecurity Follow-Up Intervention Ordered or Performed"
497 
498 define "Transportation Insecurity Numerator 4: Transportation Insecurity Screen Positive With Intervention Performed":
499   /*Transportation Insecurity Numerator 4: Transportation Insecurity Screen Positive With Intervention Performed*/
500   
501   "Inpatient Encounter" Hospitalization
502     where exists ( "Transportation Insecurity ICD10CM Diagnosis"
503         union "Transportation Insecurity Positive Screen"
504     )
505       and exists "Transportation Insecurity Follow-Up Intervention Ordered or Performed"
506 
507 define "Utility Insecurity Numerator 4: Utility Insecurity Screen Positive With Intervention Performed":
508   /*Utility Insecurity Numerator 4: Utility Insecurity Screen Positive With Intervention Performed*/
509   
510   "Inpatient Encounter" Hospitalization
511     where exists ( "Utility Insecurity ICD10CM Diagnosis"
512         union "Utility Insecurity Positive Screen"
513     )
514       and exists "Utility Insecurity Follow-Up Intervention Ordered or Performed"
515 
516 define "Food Insecurity Numerator 5: Food Insecurity Screen Negative":
517   /*Food Insecurity Numerator 5: Food Insecurity Screen Negative*/
518   
519   "Inpatient Encounter" Hospitalization
520     where exists "Food Insecurity Negative Screen"
521       and not exists "Food Insecurity ICD10CM Diagnosis"
522 
523 define "Transportation Insecurity Numerator 5: Transportation Insecurity Screen Negative":
524   /*Transportation Insecurity Numerator 5: Transportation Insecurity Screen Negative*/
525   
526   "Inpatient Encounter" Hospitalization
527     where exists "Transportation Insecurity Negative Screen"
528       and not exists "Transportation Insecurity ICD10CM Diagnosis"
529 
530 define "Utility Insecurity Numerator 5: Utility Insecurity Screen Negative":
531   /*Utility Insecurity Numerator 5: Utility Insecurity Screen Negative*/
532   
533   "Inpatient Encounter" Hospitalization
534     where exists "Utility Insecurity Negative Screen"
535       and not exists "Utility Insecurity ICD10CM Diagnosis"
536 
537 define "Utility Insecurity Follow-Up Intervention Ordered or Performed":
538   "Inpatient Encounter" Hospitalization
539     with ( ["Intervention, Performed": "Intervention for Positive Utility Insecurity Screen"]
540       union ["Intervention, Order": "Intervention for Positive Utility Insecurity Screen"] ) UtilityInsecurityIntervention
541       such that ( Global."NormalizeInterval" ( UtilityInsecurityIntervention.relevantDatetime, UtilityInsecurityIntervention.relevantPeriod ) starts during Hospitalization.relevantPeriod )
542         or UtilityInsecurityIntervention.authorDatetime during Hospitalization.relevantPeriod
543 
544 define "Utility Insecurity Numerator 1: No Utility Insecurity Screen And No Utility Insecurity ICD-10-CM Diagnosis":
545   /*Utility Insecurity Numerator 1: No Utility Insecurity Screen And No Utility Insecurity ICD-10-CM Diagnosis*/
546   
547   "Inpatient Encounter" Hospitalization
548     where exists ( "Utility Insecurity Screen No Result"
549         union "No Utility Insecurity Screen"
550     )
551       and not exists "Utility Insecurity ICD10CM Diagnosis"
552       and not exists "Utility Insecurity PRAPARE Decline to Answer"
553       and not exists "Utility Insecurity Screen Declined by Patient"
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