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Outpatient visit definition within the visit_occurrence table

Hi,

Under the user guide of vist_occurrence table, the wording for Outpatient Visit: Person visiting dedicated ambulatory healthcare institution, at a Care Site, within one day, without bed, with physicians or medical Providers delivering service during Visit.

Would a visit “within one day”, “with a bed” also be considered as an outpatient visit?

Many thanks,
Solmaz

That’s not the best wording. Any visit lasting less than one day is considered outpatient. The gist of an outpatient visit: the person visits their healthcare provider obtains healthcare services and leaves. Sometimes is a quick visit for a flu shot or lab draw, other times it involves tests, procedures, care with different providers or departments, but the person leaves and returns home/group home/assisted living.

@Christian_Reich should we remove the “with a bed” wording? The ‘observation’ patients all have beds. Along with some other outpatient visits

Yeah, it needs improvement. By “bed” we mean something the patient lives in. With sheets and blankets, where the meals are taken, TV is watched, that kind of thing. Obviously, if in an ambulatory clinic they put you on a stretcher to cut out a mole - technically that is a bed, but that’s not what the spirit of this term is.

Can you think a better wording?

“Admitted” is a common term for the concept, I think. But do records indicate admission?

Since we are mapping a UK hospital, as a first point I looked up the NHS website and they provide the following definition on Outpatients and day patients

“… an appointment in a hospital or clinic but do not need to stay overnight, it means you’re being treated as an outpatient or a day patient. You may be having an appointment for treatment, diagnosis or a procedure.”

There is no mention of the the word “bed” on the page.

Well, I like my suggestion :slight_smile:

@solmaz.eradat has a better suggestion

Taking out “without bed” will be helpful since that is the confusing part of the phrase.

“Admitted” is a tough one because some patients are “admitted” to a hospital for outpatient procedures. The term seems to be applied more to the care site versus actually staying overnight to receive continuous care. When a care site is a hospital or large healthcare center which has overnight patients, then “outpatients” are sometimes “admitted” for their care and then “discharged” after conclusion of care and leave same day.

Yeah, maybe overnight is sufficient. We tried to characterize the permanence of the situation, and the fact that the patient is stationary and the service comes to the patient. Hence the “bed” thing. For an ambulatory visit, the patient is running around and coming to the service. The admission is similar. It also indicates some permanence.

So, yes, let’s kill the bed. Doesn’t make a big difference to the rest of the definition: "Outpatient Visit: Person visiting dedicated ambulatory healthcare institution, at a Care Site, within one day, with physicians or medical Providers delivering service during Visit.

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I’ve created a GitHub issue here to update the documentation.

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I once slept overnight at an outpatient ambulatory clinic! Just to mess with the data.

But that’s ok. Remember: The Visit doesn’t characterize the institution (outpatient clinic), but how the patient interacted with the institution. So, for that visit you were an inpatient. We need to link it to something, otherwise we have no definition at all and the visit becomes useless.

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