Version 2.77

Term Description

The WellRx Questionnaire is patient-reported screening tool for the assessment of social determinants of health. This panel represents a revised version WellRx that includes more targeted questions about abuse. This tool has been institutionalized within the University of New Mexico Health System and the First Choice Federally Qualified Health Center.
Source: Regenstrief LOINC

Reference Information

Type Source Reference
Citation Journal of the American Board of Family MedicineCopyright ©2016 Journal of the American Board of Family Medicine Page-Reeves, Janet, Will Kaufman, Molly Bleecker, Jeff Norris, Kate McCalmont, Veneta Ianakieva, Dessislava Ianakieva, & Arthur Kaufman (2016). Addressing Social Determinants of Health in a Clinic Setting: The WellRx Pilot in Albuquerque, New Mexico. Journal of the American Board of Family Medicine 29(3): 414-418. Special themed issue on Social Determinants of Health.

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINC Name R/O/C Cardinality Example UCUM Units
93667-4 WellRX Questionnaire
Indent93668-2 In the past 2 months, did you or others you live with eat smaller meals or skip meals because you didn't have money for food?
Indent93669-0 Are you homeless or worried that you might be in the future?
Indent93670-8 Do you have trouble paying for your gas or electricity bills?
Indent93671-6 Do you have trouble finding or paying for a ride (transportation)?
Indent93672-4 Do you need daycare, or better daycare, for your kids?
Indent93673-2 Are you unemployed or without regular income?
Indent93674-0 Do you need help finding a better job?
Indent93675-7 Do you need help getting more education?
Indent93676-5 Are you concerned about someone in your home using drugs or alcohol?
Indent93677-3 Do you need help with legal issues?
Indent93682-3 Do you feel unsafe in your daily life?
Indent93683-1 Is anyone in your home threatening or abusing you?
Indent93678-1 In the last 6 months, have you been at the Emergency Department more than twice?
Indent93679-9 If Yes, How many times? {#}
Indent93680-7 In the last 6 months, have you been hospitalized?
Indent93681-5 If Yes, How many times? {#}

Fully-Specified Name

WellRx Questionnaire - revised

Survey Question

WellRX Questionnaire

Basic Attributes

First Released
Version 2.67
Last Updated
Version 2.67
Order vs. Observation
Panel Type

LOINC Terminology Service (API) using HL7® FHIR® Get Info

CodeSystem lookup$lookup?system=
Questionnaire definition