Tim Churches wrote: >On Sat, 2004-11-20 at 12:42, Thomas Beale wrote: > > >>This is part of a discussion that started off the list. The need is to >>be able to model Episodes in openEHR, while remaining compatible with >>available structures. >> >> > >See http://bmj.bmjjournals.com/cgi/content/full/329/7476/1207 > > Definition from this link: /The basic record is^ a finished consultant episode of care (the time spent under^ the care of one consultant). An admission, or spell, is defined^ as a continuous period of time spent as a patient within a trust,^ and may include more than one episode. Using HES data, we contrasted^ spell based activity and episode based activity, using myocardial^ infarction as an example. ...... /Measuring hospital activity by episode could result in^ overestimates of up to 50% for myocardial infarction. In 2.9%^ of spells, vague symptoms and signs were noted in the primary^ diagnosis of the first episode with myocardial infarction in^ the subsequent episode. Overestimates carry obvious implications^ for estimating the incidence of disease and assessing healthcare^ outcomes. --------------------
This would make the episode at Mayo as I described it a "spell"... >and http://snipurl.com/armv > > Defintion from this link: The period of admitted patient care between a formal or statistical admission and a formal or statistical separation, characterised by only one care type. I personally think this is not that useful, since older and complex patients just don't have only one care type (which I take to mean specialty). I would suggest that the most meaningful defintion of "episode" is more like the Mayo one - an admission (= acceptance by a provider institution to undertake provision of healthcare to a patient) to the point in time when the same institution performs a transfer of care to another provider - a referral of some kind to e.g. the GP, aged care home, self-care at home. But we also have to ask the question of what use is knowing where the boundaries of an episode are. Clearly cost accounting occurs at a much finer level of detail, which is easily supported by models like openEHR (to our knowledge to date at least); it seems to me that an episode is more to do with a period of legal responsibility of care by a provider (institution). - thomas - If you have any questions about using this list, please send a message to d.lloyd at openehr.org
