We have this problem, and we have the similar problem distinguishing subsequent “visits” within the same hospitalization (congregations of healthcare activities provided in hospital departments other than the ERs, I am trying to avoid the claims-term “encounter”). The choices are:
- A visit is a set of healthcare provided by the smallest organizational unit we can identify. That is usually a hospital ward or department, with the same set of doctors and nurses, where the patient is usually in the same bed. This is very real to patients.
- A visit is a hospitalization as a single hospital stay, which starts with admission to the hospital and ends with discharge from the hospital. Within that hospital visit, you could go through several different wards or departments, with transfers between them.
If we want to be able to understand the effect of different types of departments (e.g. comparing surgical or medical oncology) we need to do option 1. If we want to distinguish patients coming through the ER or not, we need option 1 (even though Zahid had an idea how we could make it work in option 2). I don’t know when you would prefer option 2, but I understand the data are usually easier to get.
Actually, this document describes exactly the same two choices, except they use “encounter” instead of “visit”, and “practitioner/location” instead of “ward/department”.
What are ADT?