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Concept id 38004515, Hospital, rolls up to both 9201 Inpatient Visit and 9202 Outpatient Visit

(Alexander Davydov) #21

The thing is it’s a bit different layer. Even being in the ICU with viral pneumonia and awaiting the test result, the patient is considered to be under the investigation.

Home Isolation is a case when a provider doesn’t always intend to visit you. That is why it’s not a hierarchy of ‘Home visit’.

(Alexander Davydov) #22

Hi @MPhilofsky,
Any update?

Before making the final decision about ‘Hospital’, let me summarize:

  • Initially, the wrong hierarchy were reported. Why do we want to get rid of the concept? It could be hanging in the concept table, but out of the hierarchy. The same way as other 6 top dogs do.
  • I didn’t really meet effective approaches in ETL to distinguish between IN/OUT patient Hospital Visits, only if it’s not specified explicitly in the source. In some data sources, encounters are specified as ‘admission’, ‘hospital’, especially when it goes to the admitted_from_concept_id area. So, all such generic Hospital stuff would be mostly mapped to 0.
  • One of the possible usecases when the differentiation between hospital and ambulatory/home visit is useful: any type of hospital visit (ER/IN/OUT-patient) might be easily associated with healthcare-acquired infection, while ambulatory visit or doctor’s hands during the home visit may cause it just sporadically.

(Melanie Philofsky) #23

Hi @Alexdavv,

No update. I never brought it up in the WG.

Back to Christian’s question:

The general test to distinguish an outpatient hospital visit from an inpatient hospital visit: does the visit last overnight or > 24 hours? It’s not perfect, but I think almost every visit will be correctly classified. There will be a few outliers, but there always are with observational data.

I still vote to

Let the ETL figure it out, so it’s as unambiguous as possible for the researchers.