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Post-SEM First Return to ED Dataset (Within 30 Days After Discharge)

melior_post_sem_return_to_ed.Rd

This dataset contains information about the first return to the ED within 30 days after discharge for patients in the SEM cohort from the Melior journal system.

Usage

melior_post_sem_return_to_ed()

Format

A data frame with 632,785 observations and 7 variables:

contact_id

Character. Unique identifier for each healthcare contact/encounter, serves as a foreign key to link with other datasets. 632,785 unique values. Original field name: KontaktId

patient_id

Integer. Patient pseudonym identifier, serves as a foreign key to link with other patient-level data. Original field name: Alias

admission_ward_patientliggaren

Character. Admission ward as recorded in the Patientliggaren system. 421,942 NA values (66.7%) - i.e. no admiottance 268 unique values including: "Egenvård" (3.8%), "MAVA" (2.8%), "AVA Med" (1.3%), "KHM" (1.2%), "ÖV" (1.2%). Original field name: Inläggningsavdelning_Patientliggaren

discharged_to

Character. Destination after discharge. 9 unique values: "Hemmet" (Home, 62.6%), "Avdelning" (Ward, 24.3%), "Primärvård" (Primary care, 5.4%), "Avvikit" (Left without notice, 2.4%), "Sjukhus" (Hospital, 2.2%), "Mottagning" (Outpatient clinic, 1.5%), "Avslutad" (Concluded, 0.5%), "Avliden" (Deceased, 0.2%), "Avvikit efter läkbed" (Left after medical assessment, 0.1%). 5,426 NA values (0.9%). Original field name: Utskriven till

discharge_date

POSIXct. Date and time of discharge from the healthcare contact. Date range: 2017-01-01 to 2020-06-09, with 99.97% of dates from 2017-2018. 5,426 NA values (0.9%). Original field name: Vardkontakt_UtskrivningDatum

admission_ward

Character. Admission ward as recorded in the Melior system. 665 unique values including: "AkutH" (3.1%), "AkutM" (3.1%), "MAVA" (2.8%), "AkutL" (2.6%), "AkutK" (2.0%). 372,400 NA values (58.9%). Original field name: Inläggningsavdelning

discharge_or_activity_date

POSIXct. Date and time of discharge or related activity. Date range nominally from 1970-01-01 to 2021-01-28, but meaningful dates are primarily from 2017-2018 (99.4% of non-NA values). Records with dates before 2017 or after 2019 (0.2% of non-NA values) likely contain recording errors. 372,591 NA values (58.9%). Original field name: Vardkontakt_UtskrivningDatum_EllerAktDatum

Source

Melior

Details

This file was extracted from the Melior electronic health record system. The original filename indicates it contains information about the first admission ward (FörstaInläggningsavdelningen) within 30 days after healthcare contacts (Inom30Dagar). The data provides insights into post-discharge care pathways for patients in the SEM cohort.

The high rate of NA values in admission-related fields (58.9%-66.7%) is expected and represents patients that came back to the ED but then were sent home/to primary care.

Note

  • The admission_ward field from Melior should be considered more accurate than admission_ward_patientliggaren, as Patientliggaren data may contain errors due to manual changes that might not reflect the actual ward placement.

  • The majority of patients (62.6%) are discharged to home ("Hemmet"), while a substantial proportion (24.3%) are transferred to another ward ("Avdelning").

  • POSIXct fields are stored in datetime format.

  • The discharge_or_activity_date field contains some anomalous dates outside the expected 2017-2019 range, including dates from 1970 (likely system defaults) and from 2020-2021 (which may be recording errors).

  • There is a small number of records (9) with discharge dates in 2019-2020 that fall outside the primary 2017-2018 data collection period but were kept for completeness.

  • The 1% mortality rate seen in the "Avliden" (Deceased) discharge destination represents in-ED mortality and should not be interpreted as overall 30-day mortality without additional analysis.

  • Original field names are preserved in the documentation for reference.

Examples