Page 316 - QAP Manual 2020
P. 316

Background Information

                                         Q#      Q                      Indicator/Intent       Other Notes                        Field Appropriate (Y/N)
                                                                                           COVID-19

                                         BI-68   Has this person ever been  Diagnosed or presumed   If No, skip to BI-73
                                                 diagnosed or presumed   diagnosed with COVID-19
                                                                                                                                  N
                                                 diagnosed with COVID-
                                                 19?

                                         BI-69   Has this person ever   Required in-patient    If No, skip to BI-73               N
                                                 required in-patient    hospitalization due to
                                                 hospitalization due to   COVID-19
                                                 COVID -19?

                                         BI-70   If this person required in-  Required intubation                                 N
                                                 patient hospitalization   during in-patient
                                                 due to COVID-19, did this   hospitalization due to
                                                 person require         COVID-19
                                                 intubation?
                                         BI-71   If this person required in-  Sent to ICU during in-                              N
                                                 patient hospitalization   patient hospitalization
                                                 due to COVID-19, was this
                                                 person sent to the
                                                 Intensive Care Unit (ICU)?











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