Continuous Stay

This article is about Multiple Encounter patients who have not been discharged in between encounters.

Definition

Not sure where this is used, but using Visit Admit DtTm is likely cleaner. You back-populated that for old records, so that definition would work even for old records.

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A pair of records for the same patient is a continuous stay if:

• Dispo DtTm 1 and admit2 are 5 or fewer minutes apart in the same hospital

This will likely have changed when we eliminated the 5 minute rule for local transfers; Julie, could you confirm that this was also changed wherever it has an impact? Does this use Arrive DtTm or Accept DtTm in the new schema?

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• Dispo DtTm 1 and admit2 are between 30 * minutes and 48 hrs apart in different hospitals

Does this use Arrive DtTm or Accept DtTm in the new schema?

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• the combination of Dispo field field in the first the Service/Location field in the second match
• the Previous Location field in the second and the Service/Location field in the first match
• the first admission doesn't end with Dispo field = AMA

That last line seems to be obvious in new schema from the other definitions... is AMA still at all relevant here or can it be taken out?

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Continuous encounter with intermission at non-collected ward

If all of

• Dispo field and Previous Location field are both <local hospital>
• Dispo field on the first record is the same as Previous Location field on the second
• the two fields are not a collected ward

then this is likely a continuous stay.

Continuous encounter with intermission in OR

For ICU patient transferring to another ICU area Or ICU patient who went to OR and/or comes from OR or Recovery to an ICU between same or different hospital, the max time to consider a continuous link is <= 2days (48 hours). If more than 2 days, the next ICU admission is considered as new admission and not a transfer.

would it make sense to take out the ICU requirement for this? The same might be rarer for Medicine patients but would still be true. I will implement Encounter processing like that for now unless I hear otherwise. Ttenbergen 12:06, 2015 January 22 (CST) Glad you put that in Tina, I was going to make a similar comment.--CMarks 12:48, 2015 January 22 (CST)

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Reports using this concept

Which ones?

Definition used in SAS (ie in reports)

As per email from Julie:

The program in Med is defining the conditions of new admission and if not TRUE will all be categorized as continuous stay (the cut off values are consulted and approved by Dr Roberts). Yours is the other way around, you are defining the continuous stay and if not TRUE will be a new admission. 

Criteria for new admission per hospital:
   1. Pts who have first and only admission
   2. AMA Patient from prior admission
   3. Patient is transferred to a different hospital, the admission for that hospital ends and the patient becomes a new admission to the second hospital 
        (a) except if reason is lab test and stay in the second hospital <1 day bec bed is usually put on hold on the first hospital

This def of Bed holds is not consistent with the one in Bed holds; they probably should be, i.e. the same definition should be used throughout. Are they actually consistent in your program? Can we remove the detail from here and link to bed hold?

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   4. Pts with previous encounters and admitted from ER, Home, Outside City or Province or previously discharged to Home, Outside City or Province
   5. Pts with previous encounters and admitted from unit within the hospital but the prior encounter was discharged to Home, Outside City or Province
   6. Pt discharge to or admit from  OR/ RR but more than 7 days 
   7. Pt discharge to Ward or then admit from  OR/ RR but more than 30 days
   8. Pt discharge to Ward or then admit from  Ward but var1 is not same as previous var2
   9. None of the above but has gap > 90 days then consider new admission 

Critical Care is different and much simple.  Allan Garland prescribed it based on the paper he did. Link one or more ICU whether same or diff hospitals. 
   Sept 7, 2012 Dr Allan Garland definition if linked ICU
   1. Gap <= 24 hr and (TO=blank or from=blank)
   2. Gap <= 48 hr and previous to = ICU/OR/PACU and from = ICU/OR/PACU
   3. I added the cases discharge to CCU but database has no HSC CCU prior May 1999 **;
           From= CCU/OR/PACU and previous to= CCU and 2 < diff < 20  

Julie

Related articles

Need to update this with new fields.