View source for LOS

== review needed ==
{{TT | this article has evil twins, need to reconcile, search for LOS Ttenbergen 21:13, 2014 October 23 (CDT)}}

{{Discuss | 
* This needs to be updated for [[Accept DtTm]] and [[Arrive DtTm]], and then for [[Service tmp entry]] and [[Boarding Loc]] instead. 
}}

See: [[:Category: Length of stay]] 

For our purposes, '''LOS (length of stay)''' is the combined number of '''days''' a patient spent on units on which we collect data. It is '''not''' the amount of time spent in the hospital as we don't have access to hospital admit/discharge data. 
Depending on the type of LOS, the summary statistics namely, Mean, Median, Sum or Total are included in our [[monthly report|monthly]], [[quarterly report|quarterly]] and [[annual report|annual]] reports.
{{Discuss | Those links point to collections of reports which isn't helpful, should be individual reports. And they don't need to be listed here at all if the report pages themself link to this page properly.
}}

* General definition of LOS = difference between the start datetime and end datetime where start datetime and end datetime definitions vary depending on the type of LOS.

''For example'':
* Start Date/Time: 20 May 2008 11:30
* End  Date/Time: 21 May 2008 17:45
* LOS = 1.260   (3 decimal digit accuracy is used for individual patients, 1 digit for averages)

== different kinds of LOSs ==
*Dr. Allan Garland and Julie met March 12, 2014 and identifed the different types of LOS currently calculated and reported as well as assigned a name to each one accordingly. 

===LOS_Record===
* refers as the Length of Stay (LOS) per record 
**Before Oct 1, 2020 - a record is defined as an admission in specific Internal Medicine ward or  Critical Care Unit. see [[Site_and_Location_table]]
**Starting Oct1, 2020 - a record  for Critical Care, see [[Definition of a Critical Care Laptop Admission]] and a record for Internal Medicine, see [[Definition of a Critical Care Laptop Admission]]. 
* LOS is simply calculated as the difference between the End Date and time  and Start Date and time of stay. 
** Start Date  and time is defined by either of these fields: 
*** [[Accept DtTm]] 
***  [[Arrive DtTm]]  
*** '''first Service Start DtTm''', see  [[Service_tmp_entry]]
** End Date and time is defined by the [[Dispo DtTm]]

===LOS_Cum_Wards_Hosp===
* refers as Within Hospital Medicine Ward Cumulative LOS 
** this is the sum of all Medicine wards' LOS_Record within one Hospital admission per hospital. It is important to determine correctly the different wards the patient stayed within a hospital admission and this is done by using the time gaps between records and/or the locations the patient came from and went to. If a patient stayed in more than one Medicine wards during his hospital admission until he left the hospital, then all his wards' LOS_Record were added. 
**The summary reports  separate those who left the hospital or died  and those who went to another service  within the hospital.
{{Discuss | who = Julie | question = 
* would this be simply LOS per profile now that we do [[PatientFollow Project]]? Or would you have linked together e.g. a med pt prior to ICU/un-collected ward stay and then again after?
}}
{{Discuss | who = Julie | question = 
* is this [[LOS Medicine per hospital admission]]? 
}}

===LOS_Elapse_Ward1_Hosp===
*refers to the length of stay from the FIRST ward admission until the last discharge date during one hospital admission per hospital. 
**First, identify the FIRST ward the patient stayed and the last ward or ICU unit the patient stayed during a given hospital admission per hospital.
**Then calculate the difference between the LAST Discharge Date and the First Admit Date as the elapse LOS. 
**If the patient has prior stay in ICU before the first ward stay, the prior ICU stay is not included. 
**The summary reports  separate those who left the hospital or died  and those who went to another service  within the hospital.

{{DJ |
* Is this still used? If so, can we re-define it as "first [[Service tmp entry]] until last [[Dispo DtTm]] per [[Visit Admit DtTm]]" ?
}} 

===LOS_ICU_Region===
*refers to the length of continuous stay in one or more ICU on same or different hospitals in the region 
**First, identify  the patient who had tranferred to another ICU/OR/Recovery  area on same of different hosp within 48 hours and consider their ICU stays as continuous ICU stay.
**Then calculate the difference between the Discharge Date of the last ICU stay and the  Admit Date of the First ICU stay.
**The summary reports include all patients with continuous ICU stay.

=== See also ===
{{Discuss | who = Julie | question = [[LOS Medicine per hospital admission]] and [[LOS Medicine per ward stay]] may duplicate content above. Do they? If we ever split these out into reporting documentation indicator pages we will need to make sure these are not duplicated.  }}

== Legacy ==
===Short stay===
* '''resuscitated''' patients with a short LOS used to be ignored, see https://ccmdb.kuality.ca/index.php?title=Definition_of_a_Critical_Care_Laptop_Admission&direction=next&oldid=48590

===LOS vs TISS LOS ===
* '''LOS vs TISS LOS''' - [[TISS76-2 hour rule]] used to mean that # of TISS days might be different than LOS. This is no longer the case as of [[TISS28]].

== Related Articles ==
{{Related Articles}}

[[Category:Standards and Conventions]]
[[Category: Statistical Analysis]]
[[Category: Length of stay]]
[[Category: Multiple Encounter linking]]