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Mapping DISCHARGED_TO_CONCEPT_ID inquiry

CDM Builders
#1

Hi , we are now in ETL preparation and we have In-Patient table contain the following discharges:

  1. Non Eligible
  2. Discharge Home (Continue)
  3. Transfer
  4. Send Back to Original Hospital
  5. Expired
  6. Other
  7. Scheduled to be Re-admission
  8. Hopeless Discharge
  9. null value
    we need some help to map these discharges to their associated CONCEPT_ID with visit Domain
    thanks
#2

@alruod:

The “discharge to” (and the visit concept, and the admission from) collects visit concepts. These are configurations of healthcare encounters, not individual institutions or flavors of null. Therefore, your job is easy, as most of them do not contain any analyzable information:

  1. Non Eligible - Null
  2. Discharge Home (Continue) - Null
  3. Transfer - Null
  4. Send Back to Original Hospital - 8717 “Inpatient Hospital”
  5. Expired - Null
  6. Other - Null
  7. Scheduled to be Re-admission - Null
  8. Hopeless Discharge - Null
  9. null value - Null
#5

Thanks for your support Mr. Christian
another question if you don’t mind, in visit_detail Table we will record the data from Lab,Medication and diagnosis tables with VISIT_DETAIL_CONCEPT_ID for Lab 32036 (Laborotry Visit),for Medication 581458 (Pharmacy Visit) and we don’t know which concept diagnosis belongs to.
we will appreciate you help.

#6

Probably not. The Visit Detail really only makes sense inside a hospitalization: You go from ER to ICU, to ordinary ward, to rehab. You don’t really walk over to the pharmacy to get your drugs while in a hospital bed. You also don’t visit a lab to get tested, the nurse draws your blood in the morning.

So:

  • Ambulatory setting: All these are individual visits (in VISIT_OCCURRENCE)
  • Inpatient setting: All activities are VISIT_DETAIL records, but I would pick and chose what to put in there. ICU is fine, Lab probably not.

If you think you don’t want to pick, because you don’t really know, it’s probably ok to make everything inside a hospital Visit a Visit Detail. Nobody is going to kill you.

#7

@alruod

On May 8th, the Healthcare System Interest Group discussed the Discuss Visit Occurrence and Visit Detail tables, including questions about how to define inpatient versus outpatient visits, how to define visits which belong in Visit Occurrence, visits which belong in Visit Detail, how to populate the fields in this table, what to do when some source data have datetime and other data only have dates, etc. You might want to review the recording located here.

#8

Even the Persons not really walk to pharmacy or lab, he\she engaged with the healthcare system for a duration of his\her stay and the test results or drugs was recorded in EHR.

to make it more clear to discuss
we have ER_Patients contain emergency and IP_Patients contain In Patients stays information and OP_Patients contain Outpatient information.
person may:

  1. get in as emergency case then discharged same day or next day (it will be one visit)
  2. get in as emergency case then move to InPatient same day or next day and visit some Outpatient
  3. get in as emergency case then visit some Outpatient
    for 2&3 how to deal with this cases, merge all visit to one if yes what’s the concept will take? or record each visit as separated visit
#9

True. I would:

  1. Correct.
  2. Have two records in VISIT_OCCURRENCE (ER and inpatient) and the outpatient visits during the inpatient as VISIT_DETAIL. (After the inpatient stay is over, they of course are also VISIT_OCCURRENCE).
  3. Independent VISIT_OCCURRENCE records. ER visits, like outpatient visits are one day events (exceptions can happen if the patient work is not done by midnight, but never more than 2 days). They can happen on the same day.
#10

Thanks a lot for your efforts.
please be patient with my inquiries due to non medical background.

I will share with you our raw data tables and we trying to do our best with first ETL mission.
CDM Table(s) => Source table(s)

  1. PERSON & DEATH => Demographics Table
  2. VISIT_OCCURRENCE => ER,OP and IP Tables
  3. MEASURMENT => Lab Table
  4. CONDITION_OCCURRENCE => Diagnosis Table
  5. DRUG_EXPOSURE => Medication Table
  6. PROCEDURE_OCCURRENCE => Surgery Table
  7. OBSERVATION => Lab ,Diagnosis ,Medication and Surgery
  8. OBSERVATION_PERIOD => MIN(start_date) as observation_period_start_date, MAX(end_date) as observation_period_end_date from VISIT_OCCURRENCE table.

This is what we have done so far.
any comments or recommendations or guidance will be appreciated.
thanks at all.

#11

the link need a username and password to login to ohdsi SharePoint

#12

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