Hello!
We previously used Home (concept_id = 8536) for the discharged_to_concept_id field in the visit_occurrence table. However, this concept is no longer a valid standard option and now maps to Home Visit (concept_id = 581476), and there is no standard “Home” concept in the Visit domain that can be used for discharged_to_concept_id.
According to the OMOP documentation:
“discharged_to_concept_id: This concept is part of the visit domain and can indicate if a patient was transferred to another hospital or sent to a long-term care facility, for example. It is assumed that a person is discharged to home therefore there is not a standard concept id for ‘home’. Use concept id = 0 when a person is discharged to home.” https://ohdsi.github.io/CommonDataModel/cdm54.html#visit_occurrence
Because we have a large volume of records without discharge information, we would like to differentiate between “Home” and “No information”, rather than treating both as concept_id = 0.
No need. Discharge to by definition means another visit concept, which is a healthcare encounter. Meaning, the care is not over, but continues elsewhere in the healthcare system. If the patient is discharged home, or to the cruise ship, or to prison, or to the foreign legion, or any other place is none of our business.
“No information” is a flavor of null, and we don’t record it in principle. What you mean by “home” is perhaps “Not another healthcare facility”. But we don’t record negative information either. We break the tools, if we start doing that.
Ha! I will have to disagree with this. It’s very common at health systems to know if a person was discharged home or left without the advice of the physician. Granted this might not be useful for large scale analyses, but they are useful information for health systems and other PCORI style studies.
@MPhilofsky what is your experience and how do you handle this at your institution?
We keep the full discharge string text in the discharge_to_source_value field and then map it to 0. We do not have a use case for knowing if they went AMA or were discharged. And when we give OMOP datasets to our researchers, we give them the value in discharge_to_source_value because it is always more granular than the standard concept_ids.