Type of discharge


Parameter Case Report Form and Response Options

Type of discharge
Alive
Admission to hospital
Referral to other institution
Death
Palliative discharge
Unknown

This profile of a FHIR Observation is used to capture the type of discharge of a patient. Observation.code shall be fixed to LOINC 55128-3 Discharge disposition.

The value set binding on Observation.value[x] provides the response options as SNOMED codes.

RESPONSE OPTIONS Observation.value[x].coding
Alive 371827001 |Patient discharged alive (finding)|
Admission to hospital 32485007 |Hospital admission (procedure)|
Referral to other institution 3457005 |Patient referral (procedure)|
Death 419099009 |Dead (finding)|
Palliative discharge 306237005 |Referral to palliative care service (procedure)|
Unknown 261665006 |Unknown (qualifier value)|

Profile - Discharge Disposition

Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/discharge-disposition

Snapshot

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionC0..*Extension
modifierExtension?! C0..*Extension
identifierΣ0..*Identifier
basedOnΣ C0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)
partOfΣ C0..*Reference(ImagingStudy | Immunization | MedicationAdministration | MedicationDispense | MedicationStatement | Procedure)
statusΣ ?!1..1codeBinding
id0..1string
extensionC0..*Extension
observationCategoryΣ1..1CodingPattern
textΣ0..1string
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ1..1uriPattern
versionΣ0..1string
codeΣ1..1codePattern
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
subjectS Σ C1..1Reference(Patient)
focusΣ C0..*Reference(Resource)
encounterΣ C0..1Reference(Encounter)
effectiveDateTimedateTime
effectiveInstantinstant
effectivePeriodPeriod
effectiveTimingTiming
issuedΣ0..1instant
performerΣ C0..*Reference(CareTeam | Organization | Patient | Practitioner | PractitionerRole | RelatedPerson)
valueBooleanboolean
valueDateTimedateTime
valueIntegerinteger
valuePeriodPeriod
valueQuantityQuantity
valueRangeRange
valueRatioRatio
valueSampledDataSampledData
valueStringstring
valueTimetime
id0..1string
extensionC0..*Extension
id0..1string
extensionC0..*Extension
systemΣ1..1uriPattern
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
dataAbsentReasonC0..1CodeableConceptBinding
interpretation0..*CodeableConceptBinding
note0..*Annotation
bodySite0..0CodeableConcept
method0..1CodeableConcept
specimenC0..0Reference(Specimen)
deviceC0..1Reference(Device | DeviceMetric)
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
lowC0..1SimpleQuantity
highC0..1SimpleQuantity
type0..1CodeableConceptBinding
appliesTo0..*CodeableConcept
ageC0..1Range
text0..1string
hasMemberΣ C0..*Reference(MolecularSequence | Observation | QuestionnaireResponse)
derivedFromΣ C0..*Reference(DocumentReference | ImagingStudy | Media | MolecularSequence | Observation | QuestionnaireResponse)
id0..1string
extensionC0..*Extension
modifierExtensionΣ ?! C0..*Extension
codeΣ1..1CodeableConcept
valueBooleanboolean
valueCodeableConceptCodeableConcept
valueDateTimedateTime
valueIntegerinteger
valuePeriodPeriod
valueQuantityQuantity
valueRangeRange
valueRatioRatio
valueSampledDataSampledData
valueStringstring
valueTimetime
dataAbsentReasonC0..1CodeableConceptBinding
interpretation0..*CodeableConceptBinding
referenceRange0..*see (referenceRange)


ValueSets

Valuesets are provided with SNOMED-CT codes.

Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/ValueSet/discharge-disposition

This value set includes codes from the following code systems:


Examples

Patient discharged alive

{
"resourceType": "Observation",
"id": "discharge-disposition-alive",
"meta": {
"profile": [
"https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/discharge-disposition"
]
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "OBI"
}
]
},
"system": "https://www.charite.de/fhir/CodeSystem/observation-identifiers",
"value": "55128-3_DischargeDisposition",
"reference": "Organization/Charité"
}
}
],
"status": "final",
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "55128-3",
"display": "Discharge disposition"
}
],
"text": "Type of discharge"
},
"subject": {
"reference": "Patient/gecco-patient"
},
"effectiveDateTime": "2020-10-16T08:49:21+02:00",
"coding": [
{
"system": "http://snomed.info/sct",
"code": "371827001",
"display": "Patient discharged alive (finding)"
}
]
}
}


Patient admitted to hospital

{
"resourceType": "Observation",
"id": "discharge-disposition-hospital-admission",
"meta": {
"profile": [
"https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/discharge-disposition"
]
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "OBI"
}
]
},
"system": "https://www.charite.de/fhir/CodeSystem/observation-identifiers",
"value": "55128-3_DischargeDisposition",
"reference": "Organization/Charité"
}
}
],
"status": "final",
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "55128-3",
"display": "Discharge disposition"
}
],
"text": "Type of discharge"
},
"subject": {
"reference": "Patient/gecco-patient"
},
"effectiveDateTime": "2020-10-16T08:49:21+02:00",
"coding": [
{
"system": "http://snomed.info/sct",
"code": "32485007",
"display": "Hospital admission (procedure)"
}
]
}
}


Patient refered to other institution

{
"resourceType": "Observation",
"id": "discharge-disposition-referral",
"meta": {
"profile": [
"https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/discharge-disposition"
]
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "OBI"
}
]
},
"system": "https://www.charite.de/fhir/CodeSystem/observation-identifiers",
"value": "55128-3_DischargeDisposition",
"reference": "Organization/Charité"
}
}
],
"status": "final",
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "55128-3",
"display": "Discharge disposition"
}
],
"text": "Type of discharge"
},
"subject": {
"reference": "Patient/gecco-patient"
},
"effectiveDateTime": "2020-10-16T08:49:21+02:00",
"coding": [
{
"system": "http://snomed.info/sct",
"code": "3457005",
"display": "Patient referral (procedure)"
}
]
}
}


Patient discharged dead

{
"resourceType": "Observation",
"id": "discharge-disposition-dead",
"meta": {
"profile": [
"https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/discharge-disposition"
]
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "OBI"
}
]
},
"system": "https://www.charite.de/fhir/CodeSystem/observation-identifiers",
"value": "55128-3_DischargeDisposition",
"reference": "Organization/Charité"
}
}
],
"status": "final",
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "55128-3",
"display": "Discharge disposition"
}
],
"text": "Type of discharge"
},
"subject": {
"reference": "Patient/gecco-patient"
},
"effectiveDateTime": "2020-10-16T08:49:21+02:00",
"coding": [
{
"system": "http://snomed.info/sct",
"code": "419099009",
"display": "Dead (finding)"
}
]
}
}


Patient discharged to palliative care

{
"resourceType": "Observation",
"id": "discharge-disposition-palliative-care",
"meta": {
"profile": [
"https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/discharge-disposition"
]
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "OBI"
}
]
},
"system": "https://www.charite.de/fhir/CodeSystem/observation-identifiers",
"value": "55128-3_DischargeDisposition",
"reference": "Organization/Charité"
}
}
],
"status": "final",
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "55128-3",
"display": "Discharge disposition"
}
],
"text": "Type of discharge"
},
"subject": {
"reference": "Patient/gecco-patient"
},
"effectiveDateTime": "2020-10-16T08:49:21+02:00",
"coding": [
{
"system": "http://snomed.info/sct",
"code": "306237005",
"display": "Referral to palliative care service (procedure)"
}
]
}
}


Discharge type unknown

{
"resourceType": "Observation",
"id": "discharge-disposition-unknown",
"meta": {
"profile": [
"https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/discharge-disposition"
]
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "OBI"
}
]
},
"system": "https://www.charite.de/fhir/CodeSystem/observation-identifiers",
"value": "55128-3_DischargeDisposition",
"reference": "Organization/Charité"
}
}
],
"status": "final",
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "social-history"
}
]
}
],
"code": {
"coding": [
{
"system": "http://loinc.org",
"code": "55128-3",
"display": "Discharge disposition"
}
],
"text": "Type of discharge"
},
"subject": {
"reference": "Patient/gecco-patient"
},
"effectiveDateTime": "2020-10-16T08:49:21+02:00",
"coding": [
{
"system": "http://snomed.info/sct",
"code": "261665006",
"display": "Unknown (qualifier value)"
}
]
}
}