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Added THEMIS issues to Payer_plan_period

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clairblacketer 2018-10-02 12:20:29 -04:00 committed by GitHub
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Documentation/CommonDataModel_Wiki_Files/StandardizedHealthEconomicsDataTables/PAYER_PLAN_PERIOD.md
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@ -31,4 +31,5 @@ No.|Convention Description
| 1 | Different Payers have different designs for their health benefit Plans. The PAYER_PLAN_PERIOD table does not capture all details of the plan design or the relationship between Plans or the cost of healthcare triggering a change from one Plan to another. However, it allows identifying the unique combination of Payer (insurer), Plan (determining healthcare benefits and limits) and Person. Typically, depending on healthcare utilization, a Person may have one or many subsequent Plans during coverage by a single Payer. |
| 2 | Typically, family members are covered under the same Plan as the Person. In those cases, the payer_source_value, plan_source_value and family_source_value are identical. |
| 3 | The contract_person_id is meant to refer to the owner of the plan, for instance, a parent who owns the plan under which the child is covered. Contract_person_id many times will be equal to person_id. |
| 4 | The fields contract_source_value and contract_concept_id justify the contract relationship.<br><ul><li>It is represented as the relationship from the person_id to contract_person_id. We will use SNOMED vocabulary of the Relationship Domain and Social Context concept class id (see [here](http://athena.ohdsi.org/search-terms/terms?vocabulary=SNOMED&domain=Relationship&conceptClass=Social+Context&page=1&pageSize=15&query=). For example:<br><ul><li>Person_id is the spouse ([4132413](http://athena.ohdsi.org/search-terms/terms/4132413)) of contract_person_id</li><li>person_id is the child ([4285883](http://athena.ohdsi.org/search-terms/terms/4285883)) of the contract_person_id</li></ul>
| 4 | The fields contract_source_value and contract_concept_id justify the contract relationship.<br><ul><li>It is represented as the relationship from the person_id to contract_person_id. We will use SNOMED vocabulary of the Relationship Domain and Social Context concept class id (see [here](http://athena.ohdsi.org/search-terms/terms?vocabulary=SNOMED&domain=Relationship&conceptClass=Social+Context&page=1&pageSize=15&query=). For example:<br><ul><li>Person_id is the spouse ([4132413](http://athena.ohdsi.org/search-terms/terms/4132413)) of contract_person_id</li><li>person_id is the child ([4285883](http://athena.ohdsi.org/search-terms/terms/4285883)) of the contract_person_id</li></ul>
| 5 | A patient can have multiple overlapping payer plan periods ([THEMIS issue #18](https://github.com/OHDSI/Themis/issues/18)).