OMOP/Documentation/CommonDataModel_Wiki_Files/StandardizedClinicalDataTables/VISIT_DETAIL.md

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The VISIT_DETAIL table is an optional table used to represents details of each record in the parent visit_occurrence table. For every record in visit_occurrence table there may be 0 or more records in the visit_detail table with a 1:n relationship where n may be 0. The visit_detail table is structurally very similar to visit_occurrence table and belongs to the same visit-domain in OMOP CDM. The two key difference from visit_occurrence is the presence of new foreign keys pointing to itself (visit_detail_parent_id) and to visit_occurrence table (visit_occurrence_id)
Field|Required|Type|Description
:------------------------|:--------|:-----|:-------------------------------------------------
|visit_detail_id|Yes|integer|A unique identifier for each Person's visit or encounter at a healthcare provider.|
|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.|
|visit_detail_concept_id|Yes|integer|A foreign key that refers to a visit Concept identifier in the Standardized Vocabularies.|
|visit_start_date|Yes|date|The start date of the visit.|
|visit_start_datetime|No|datetime|The date and time of the visit started.|
|visit_end_date|Yes|date|The end date of the visit. If this is a one-day visit the end date should match the start date.|
|visit_end_datetime|No|datetime|The date and time of the visit end.|
|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.|
|provider_id|No|integer|A foreign key to the provider in the provider table who was associated with the visit.|
|care_site_id|No|integer|A foreign key to the care site in the care site table that was visited.|
|visit_source_value|No|string(50)|The source code for the visit as it appears in the source data.|
|visit_source_concept_id|No|Integer|A foreign key to a Concept that refers to the code used in the source.|
|admitting_source_value |Varchar(50)| No| The source code for the admitting source as it appears in the source data.|
|admitting_source_concept_id| |Integer |No |A foreign key to the predefined concept in the Place of Service Vocabulary reflecting the admitting source for a visit.|
|discharge_to_source_value| Varchar(50)| No| The source code for the discharge disposition as it appears in the source data.|
|discharge_to_concept_id| Integer |No |A foreign key to the predefined concept in the Place of Service Vocabulary reflecting the discharge disposition for a visit.|
|preceding_visit_detail_id |Integer| No |A foreign key to the VISIT_DETAIL table of the visit immediately preceding this visit|
|visit_detail_parent_id |Integer| No |A foreign key to the VISIT_DETAIL table record to represent the immediate parent visit-detail record.|
|visit_occurrence_id |Integer| No |A foreign key that refers to the record in the VISIT_OCCURRENCE table|
### Conventions
* All conventions used in Visit occurrence apply to visit detail, some notable exceptions:
* A Visit Detail is an optional detail record for each visit-occurrence to a healthcare facility. For every record in visit_detail there has to be a parent visit_occurrence record.
* One record is visit_detail can only have one visit_occurrence parent.
* A single visit_occurrence record may have many child visit_detail records.
* Valid Visit Concepts belong to the "Visit" domain. Standard Visit Concepts are yet to be defined, but will represent a detail of the standard visit concept in visit-occurrence.
* Handling of death: Is same as visit_occurrence
* Source Concepts from place of service vocabularies are mapped into these standard visit Concepts in the Standardized Vocabularies.
* At any one day, there could be more than one visit. Visit_occurrence allows for more than one visit within single day. Visit_detail is to be used to only capture details within the visit_occurrence.
* One visit may involve multiple providers, in which case, in visit_occurrence, the ETL must specify how a single provider id is selected or leave the provider_id field null. Visit_detail allows for ETL to speicify multiple child records per visit_occurrence - and each of these child may represent different provider_ids.
* One visit may involve multiple Care Sites, in which case, in visit_occurrence, the ETL must specify how a single care_site id is selected or leave the care_site_id field null. Visit_detail allows for ETL to speicify multiple child records per visit_occurrence - and each of these child may represent different care_sites.
* Just like in visit_occurrence, records in visit_detail may be sequentially related to each. These sequential relations are represented using preceding_visit_detail_id
* Unlike visit_occurrence, visit_detail may have nested visits with hierarchial relationships to each other.
* Representation of US claim data: US claims data generally has two-levels. Header/summary data that summarizes the entire claim; Line/detail that details a claim. Detail is thus a child of the summary, and for every record in summary there is one or more records in detail. i.e. there will be atleast one FK link from visit_detail to visit_occurrence.
Example: an entire inpatient stay maybe one record in visit_occurrence table. This may have one or more detail information such as ER, ICU, medical floor, rehabilitation floor etc. Each of these visit_details may have different start/end date-times, different concept_id's and fact_id's - that would be separate record in visit_detail with a FK link to visit_occurrence. Each record within visit_detail maybe related to each other, sequentially > ER leading to ICU leading to medical floor, leading to rehabilitation, or in hierarchical parent-child visit > a visit for dialysis while in ICU.