--- Tim Churches <tchur at optushome.com.au> wrote:
> On Sat, 2004-11-20 at 20:19, Thomas Beale wrote:
>
> > >and http://snipurl.com/armv
>
> (which is the Australian definition)
>
> > >
> > 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).
>
> Although you would never know it from the web page, by "care type", they
> mean "acute care" versus "rehabilitation" versus "psychiatric". These
> distinctions are purely administrative and have no definitive clinical
> or epidemiological meaning. Nevertheless, it is teh basis of all
> official Australian hospital statistics. The British definitions are
> much better, I think.
>
> >
> > 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.
>
> We refer to that as a "separation" - which begins with inpatient
> admission to a healthcare facility and ends with discharge, transfer or
> death. You also need rules for "leave" - some patients (eg long-term
> psych patients, rehab patients) go on leave during the course of one
> admission/separation.
>
> > 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);
>
> Hospital- and ward-level cost accounting might take place at finer
> levels of detail, but hospital funding tends to use these
> administrative/"statistical" definitions, as noted in the BMJ article.
> An EHR repository will not curry much favour with administrators (who
> tend to hold the purse-strings) if it can't give them the information
> they want (which is not necessarily what they need...)
>
> > it seems to me that an episode is
> > more to do with a period of legal responsibility of care by a provider
> > (institution).
>
> Episodes could be called "funding temporal units".
>
> Tim C
>
>
> -
> If you have any questions about using this list,
> please send a message to d.lloyd at openehr.org
>
___________________________________________________________
ALL-NEW Yahoo! Messenger - all new features - even more fun!
http://uk.messenger.yahoo.com
-
If you have any questions about using this list,
please send a message to d.lloyd at openehr.org
