Re-analysis and generation of Overstay2 model: Difference between revisions

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 * '''Reference Admit DtTm:''' We based the date range on the first medicine admit date during a [[Data definition for contributing factors for the Overstay2 project#Hospitalization]], based on the earliest [[Boarding Loc]] dttm.
-* '''Dataset inclusion criteria:
+* '''Dataset inclusion criteria: (all/and) of the following
 ** ''Reference Admit DtTm'' >=2020-11-01 and <2025-01-01
-::: and
+** [[RecordStatus]] = Vetted
-:* [[RecordStatus]] = Vetted
+** final [[dispo]] of the [[Data definition for contributing factors for the Overstay2 project#Hospitalization]] is to a destination outside of the hospital of the admission (can be to other hospital)
+** HOBS: include the record only if:
+*** the first medicine admission during a hospitalization is on a HOBS unit, and
+*** there is a Transfer_Ready_Dttm associated with that unit, and
+*** the patient is discharged from that unit to a non-hospital location
+{{DJ |
+* is this really simply "to a non-hospital location" or is it the same as above: "to a destination outside of the hospital of the admission (can be to other hospital)"?
+}}
 * This resulted in a dataset with the following:
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 * First Med Admits who were still in the unit are excluded (ie no [[Dispo DtTm]])
 * First Med Admits who were [[RecordStatus]] = vetted are included.
+* Deceased should be included: I think there was talk about excluding these; I don’t think that is valid. We don’t know when they arrive that they will die, and if they die after becoming transfer ready that is still an overstay we could have avoided.
+* Discharge to or Previous Location = Hospice should be included – for the same reason we would include PCH.
+* Palliative patients should be included
+** because our definition “Palliative care” (ICD10 Z51.5) doesn’t imply death is imminent. Palliative patients were excluded before, but our definition has changed, and how this appears to be handled now has as well. Also, they may be waiting in hospital for a hospice, so again, that’s overstay.
+** Discharged to  STB Palliative  Care - -included  (DR agreed in the meeting with JM feb10)
+* AMA – include these.
+** Initial thought was that AMA implies they were not discharge ready, but it could also include those who were sick of waiting for a PCH and walked out. They might just be someone who waited for 2 weeks while dispo ready and eventually ran away because they did not want to wait for home care or etc any longer. But can someone be transfer ready and still leave AMA? Yes, e.g. when they were transfer ready but the discharge took so long that they no longer are and now can leave AMA again.
+*** JM found 3061 dispo AMA (2810 wo TR_dt, 251 w TR_Dt)
+* Dispo TCU/TCE – include, and treat as discharge from this hospital
+* Dispo HSC Lennox Bell/Institution NOS – treat as we would back-to-PCH/home
+* Dispo another ward within WPG  (LAU at CON, OAKS, VIC)? – include, and treat as discharge from this hospital
+* Unknown disposition at discharge on the last admission – those transferred to another service (ICU/ OR/ etc within the same hospital - already excluded with RecordStatus = ”incomplete” and by only including if (1c)
+* Dispo Transfers to different hospital ICU within Winnipeg – include
+* Transfers outside WPG – include and treat as if discharged
+* Overstay 5 to 9 days   - included as normal (Rodrigo excluded these from model building)
+* A null Tr_DtTm will be allowed
+* This defines “hospitalization” as per-site, so if the patient is moved to subsequent medicine wards at a different hospital there will be a new record
+* EMIP / TR_DtTm during ED portion of visit: treat this as you would on the ward. The First TR DTtm  at ER will be taken regardless whether there is a second TR dttm when patient moved to a Med Med ward (DR agreed in the meeting with JM Feb10)
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