VISIT_OCCURRENCE表包含居民在医疗保健系统里的某医疗机构持续接受医疗服务的时间段，该时间段内可以有一个或者多个医疗服务者。就诊方式分为4类：门诊、住院、急诊和长期护理。居民可能在一次就诊过程（例如治疗疾病）中，在几个机构间辗转。
The VISIT_OCCURRENCE table contains the spans of time a Person continuously receives medical services from one or more providers at a Care Site in a given setting within the health care system. Visits are classified into 4 settings: outpatient care, inpatient confinement, emergency room, and long-term care. Persons may transition between these settings over the course of an episode of care (for example, treatment of a disease onset).
| Field | Required | Type | Description |
|---|---|---|---|
| visit_occurrence_id | Yes | integer | A unique identifier for each Person's visit or encounter at a healthcare provider. |
| 就诊-发生-ID | -- | -- | 每个居民在就诊或接受医疗服务的唯一标识符。 |
| person_id | Yes | integer | A foreign key identifier to the Person for whom the visit is recorded. The demographic details of that Person are stored in the PERSON table. |
| 居民-id | -- | -- | 外键，记录就诊的居民标识符。该居民的人口统计学详细信息存储在PERSON表中。 |
| visit_concept_id | Yes | integer | A foreign key that refers to a visit Concept identifier in the Standardized Vocabularies belonging to the 'Visit' Vocabulary. |
| 就诊-概念-id | -- | -- | 外键，指向“就诊”词汇表的标准化词汇表中的就诊概念的标识符。 |
| visit_start_date | No | date | The start date of the visit. |
| 就诊-开始-日期 | -- | -- | 就诊开始日期。 |
| visit_start_datetime | Yes | datetime | The date and time of the visit started. |
| 就诊-开始-日期时间 | -- | -- | 就诊开始日期和时间。 |
| visit_end_date | No | date | The end date of the visit. If this is a one-day visit the end date should match the start date. |
| 就诊-截止-日期 | -- | -- | 就诊结束日期。如果就诊在一天内完成，则截止日期应与开始日期一致。 |
| visit_end_datetime | Yes | datetime | The date and time of the visit end. |
| 就诊-截止-日期时间 | -- | -- | 就诊结束日期和时间。 |
| visit_type_concept_id | Yes | Integer | A foreign key to the predefined Concept identifier in the Standardized Vocabularies reflecting the type of source data from which the visit record is derived belonging to the 'Visit Type' vocabulary. |
| 就诊-类型-概念-id | -- | -- | 外键，指向标准词汇表中预定义的概念标识符，标识本就诊记录信息的源数据的概念类型（译者按，例如入院记录，门诊记录），属于“就诊类型”词汇表。 |
| provider_id | No | integer | A foreign key to the provider in the provider table who was associated with the visit. |
| 服务者-id | -- | -- | 外键，标识'贡献者表'中与本次就诊关联的贡献者。 |
| care_site_id | No | integer | A foreign key to the care site in the care site table that was visited. |
| 医疗-机构-id | -- | -- | 外键，标识本次就诊的对应的''服务机构表'中的服务机构。 |
| visit_source_value | No | varchar(50) | The source code for the visit as it appears in the source data. |
| 就诊-源-值 | -- | -- | 存储在源数据中的就诊信息源代码。 |
| visit_source_concept_id | Yes | integer | A foreign key to a Concept that refers to the code used in the source. |
| 就诊-源-概念-id | -- | -- | 外键，标识源数据使用的代码对应的概念id。 |
| admitted_from_concept_id | Yes | integer | A foreign key to the predefined concept in the Place of Service Vocabulary reflecting where the patient was admitted from. |
| 入院-从-概念-id | -- | -- | 外键，服务地点词汇表中预定义概念，标识居民入院前的停留地点。（译者按，对应的应该就是居住地 - 作为发病的地点来研究，做流行病学研究会常用） |
| admitted_from_source_value | No | varchar(50) | The source code for where the patient was admitted from as it appears in the source data. |
| 入院-从-源-值 | -- | -- | 源数据中存储的患者入院前停留地点的源代码。 |
| discharge_to_concept_id | Yes | integer | A foreign key to the predefined concept in the Place of Service Vocabulary reflecting the discharge disposition for a visit. |
| 出院-到-概念-id | -- | -- | 外键，指向服务地点词汇表中预定义概念，标识本次就诊的出院后的目的地。 |
| discharge_to_source_value | No | varchar(50) | The source code for the discharge disposition as it appears in the source data. |
| 出院-到-源-值 | -- | -- | 元数据中存储的患者出院后目的地的源代码。 |
| preceding_visit_occurrence_id | No | integer | A foreign key to the VISIT_OCCURRENCE table of the visit immediately preceding this visit |
| 先前-就诊-发生-id | -- | -- | 外键，标识此次就诊前经历的就诊过程对应的的VISIT_OCCURRENCE表的信息 |
共识
| No. | Convention Description | 共识 |
|---|---|---|
| 1 | A Visit Occurrence is recorded for each visit to a healthcare facility. | 每次于医疗机构就诊时都会记录一次就诊事件。 |
| 2 | Valid Visit Concepts belong to the 'Visit' domain. | 标示为“有效”的就诊概念属于“就诊”域。 |
| 3 | Standard Visit Concepts are defined, among others, as Inpatient Visit, Outpatient Visit, Emergency Room Visit, Long Term Care Visit and combined ER and Inpatient Visit. The latter is necessary because it is close to impossible to separate the two in many EHR system, treating them interchangeably. To annotate this correctly, the visit concept 'Emergency Room and Inpatient Visit' (concept_id=262) should be used. | 标准就诊概念被定义为住院就诊，门诊就诊，急诊就诊，长期护理就诊以及急诊结合住院就诊。后者是必要的，因为在许多EHR系统中将两者分开几乎是不可能的，很难区分。若要正确表示，应使用就诊概念“Emergency Room and Inpatient Visit”（concept_id = 262）。 |
| 4 | Handling of death: In the case when a patient died during admission (VISIT_OCCURRENCE.DISCHARGE_TO_CONCEPT_ID = 4216643 'Patient died'), a record in the Observation table should be created with OBSERVATION_TYPE_CONCEPT_ID = 44818516 (EHR discharge status 'Expired'). | 死亡信息的处理：如果患者在住院时死亡（VISIT_OCCURRENCE.DISCHARGE_TO_CONCEPT_ID = 4216643'Patient died'），观察表中也应使用OBSERVATION_TYPE_CONCEPT_ID = 44818516（EHR discharge status 'Expired'）建立该信息的记录。 |
| 5 | Source Concepts from place of service vocabularies are mapped into these standard visit Concepts in the Standardized Vocabularies. | 医疗地点词汇表的源概念已做映射到标准词汇表中的标准就诊概念。 |
| 6 | At any one day, there could be more than one visit. | 在某一天内，可能会有不止1次就诊行为。 |
| 7 | One visit may involve multiple providers, in which case the ETL must specify how a single PROVIDER_ID is selected or leave the PROVIDER_ID field null. | 一次就诊可能涉及多个贡献者，在这种情况下，ETL必须指定如何选择单个PROVIDER_ID或将PROVIDER_ID字段置为null。 |
| 8 | One visit may involve multiple Care Sites, in which case the ETL must specify how a single CARE_SITE_ID is selected or leave the CARE_SITE_ID field null. | 1次就诊可能涉及多个医疗机构，在这种情况下，ETL必须指定如何选择单个CARE_SITE_ID或将CARE_SITE_ID字段置为null。 |
| 9 | Visits are recorded in various data sources in different forms with varying levels of standardization. For example:Medical Claims include Inpatient Admissions, Outpatient Services, and Emergency Room visits.Electronic Health Records may capture Person visits as part of the activities recorded depending whether the EHR system is used at the different Care Sites./li> | 就诊信息以不同形式记录在各种数据源中，具有不同的标准化水平。例如：医疗理赔信息包括住院病人入院信息，门诊服务信息和急诊就诊信息。EHR（电子健康记录）可能因为某就诊信息是由不同的医疗机构使用自己的EHR系统采集的，导致将就诊记录作为分散的部分而存储。（译者按：此处不确定意译是否准确） |
| 10 | In addition to the 'Place of Service' vocabulary the following SNOMED concepts for discharge disposition (DISCHARGE_TO_CONCEPT_ID) can be used:Patient died: 4216643 Absent without leave: 44814693Patient self-discharge against medical advice: 4021968 | 除了“Place of Service”词汇表外，还可以使用以下SNOMED的出院原因概念（DISCHARGE_TO_CONCEPT_ID）：病人死亡：4216643，无故离院：44814693，患者反对医疗建议自行出院：4021968 |
| 11 | PRECEDING_VISIT_ID can be used to link a visit immediately preceding the current visit. | PRECEDING_VISIT_ID可用于关联当次就诊之前的就诊信息。 |
| 12 | Visit end dates are mandatory. If end dates are not provided in the source there are three ways in which to derive them:Outpatient Visit: VISIT_END_DATE = VISIT_START_DATEEmergency Room Visit: VISIT_END_DATE = VISIT_START_DATEInpatient Visit: Usually there is information about discharge. If not, you should be able to derive the end date from the sudden decline of activity or from the absence of inpatient procedures/drugs.Long Term Care Visits: Particularly for claims data, if end dates are not provided assume the visit is for the duration of month that it occurs.For inpatient visits ongoing at the date of ETL, put date of processing the data as mandatory VISIT_END_DATE and VISIT_TYPE_CONCEPT_ID with 32220-"Still patient" to identify the visit as incomplete.(THEMIS issue #13). | 就诊结束日期是必填的。如果数据源中没有提供结束日期，则有三种方法可以派生它们：门诊就诊：VISIT_END_DATE = VISIT_START_DATE急诊室就诊：VISIT_END_DATE = VISIT_START_DATE。住院就诊：通常有关于出院的信息。如果没有，应该能够从（医疗）活动的突然减少或缺少住院手术/药物来推得结束日期。长期护理就诊：特别是对于理赔数据，如果未提供结束日期，则假定就诊是在其发生的月份期间。对于在ETL日期进行的住院患者就诊，强制将处理数据的日期作为VISIT_END_DATE，VISIT_TYPE_CONCEPT_ID为32220-“仍在就诊”，以把就诊信息标识完整。（主题＃13） |
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