Age
Education
Marital status
Ever worked or trained in a health-related field
Eligible person
Is this person covered by any kind of health insurance plan?
Is this person covered by any mandatory health insurance plans?
Is this person covered by any voluntary health insurance plans?
How much does your household pay for this person’s voluntary health insurance each year?
Is this person covered by insurance only because of his/her relationship to someone else who has health insurance?
Who is enrolled in the insurance plan that gives this person health insurance?
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
Identify the medicines shown by the respondent in the medicine list and then record in the corresponding row in the following table. Please complete the table for a maximum of the 3 most used medicines for each condition.
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