FHIR IG analytics| Package | ca.on.mha.pds |
| Resource Type | QuestionnaireResponse |
| Id | gambling-questionnaire-sample.json |
| FHIR Version | R4 |
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FHIR
FHIRsmith{
"resourceType": "QuestionnaireResponse",
"id": "gambling-questionnaire-example",
"meta": {
"profile": [
"http://ontariohealth.ca/fhir/StructureDefinition/ca-on-mha-profile-QuestionnaireResponse"
]
},
"questionnaire": "http://ontariohealth.ca/fhir/StructureDefinition/ca-on-mha-gambling-questionnaire-template",
"status": "completed",
"subject": {
"reference": "urn:uuid:a3fb7d98-a471-42fa-ae94-d655f2393cc0"
},
"authored": "2024-03-02T14:15:00-05:00",
"item": [
{
"linkId": "Q1",
"text": "Reason for Seeking Help With Gambling Behaviour",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-help-seeking-reason",
"code": "1",
"display": "Own gambling problem"
}
}
]
},
{
"linkId": "Q2",
"text": "Number of Months Life Negatively Affected by Gambling Behaviour",
"answer": [
{
"valueInteger": 18
}
]
},
{
"linkId": "Q3",
"text": "Length of Time Since Last Gambling Activity (Days)",
"answer": [
{
"valueInteger": 30
}
]
},
{
"linkId": "Q4",
"text": "Sequence of Gambling Problem Identification",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/sequence-of-gambling-problem",
"code": "gt",
"display": "Patient came to this agency specifically for gambling treatment"
}
}
]
},
{
"linkId": "Q5",
"text": "Primary Gambling Activity in the last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-activities-in-last-year",
"code": "slots",
"display": "Played slots or other non-VLT machines"
},
"item": [
{
"linkId": "Q5-a",
"text": "Primary Gambling Activity Frequency in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-frequency",
"code": "gf-3-6 times weekly",
"display": "3-6 times weekly"
}
}
]
},
{
"linkId": "Q5-b",
"text": "Primary Gambling Location in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-location",
"code": "commercial casino",
"display": "In a commercial casino"
}
}
]
},
{
"linkId": "Q5-c",
"text": "Primary Gambling Location Frequency in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-frequency",
"code": "gf-3-6 times weekly",
"display": "3-6 times weekly"
}
}
]
}
]
}
]
},
{
"linkId": "Q6",
"text": "Additional Gambling Activity in the last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-activities-in-last-year",
"code": "sport bets",
"display": "Bets on sports(e.g., Sports Select, with a bookie)"
},
"item": [
{
"linkId": "Q6-a",
"text": "Additional Gambling Activity Frequency in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-frequency",
"code": "gf-1-3 times a month",
"display": "1-3 times a month"
}
}
]
},
{
"linkId": "Q6-b",
"text": "Additional Gambling Location in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-location",
"code": "internet",
"display": "On the Internet"
}
}
]
},
{
"linkId": "Q6-c",
"text": "Addtional Gambling Location Frequency in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-frequency",
"code": "gf-1-3 times a month",
"display": "1-3 times a month"
}
}
]
}
]
},
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-activities-in-last-year",
"code": "lottary tickets",
"display": "Bought lottery tickets(e.g., Pick 3, 6/49)"
},
"item": [
{
"linkId": "Q6-a",
"text": "Additional Gambling Activity Frequency in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-frequency",
"code": "gf-1-2 times weekly",
"display": "1-2 times weekly"
}
}
]
},
{
"linkId": "Q6-b",
"text": "Additional Gambling Location in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-location",
"code": "lottery kiosk",
"display": "Lottery kiosk/outlet"
}
}
]
},
{
"linkId": "Q6-c",
"text": "Addtional Gambling Location Frequency in last 12 months",
"answer": [
{
"valueCoding": {
"system": "http://ontariohealth.ca/fhir/CodeSystem/gambling-frequency",
"code": "gf-1-2 times weekly",
"display": "1-2 times weekly"
}
}
]
}
]
}
]
},
{
"linkId": "Q7",
"text": "Percentage of Time Spent Gambling by Jurisdiction",
"item": [
{
"linkId": "Q7-a",
"text": "Percentage of Time Spent Gambling in Ontario",
"answer": [
{
"valueInteger": 60
}
]
},
{
"linkId": "Q7-b",
"text": "Percentage of Time Spent Gambling in another province",
"answer": [
{
"valueInteger": 20
}
]
},
{
"linkId": "Q7-c",
"text": "Percentage of Time Spent Gambling Outside of Canada",
"answer": [
{
"valueInteger": 20
}
]
}
]
}
]
}