Query to compare dates patients are missing from hospital census - sql

Question

I have a hospital bed census that is triggered and creates a date/time stamped row in a table. when the bed check portion is done it labels the event census. i have found that some patients on days they were in the hospital have not been timestamped with the event census. I am trying to write a query to capture all patients that may have had this issue.
i need to capture the patients between their admit and discharge dates, and then any day they do not have a time stamp event of census. for example, this patient does not have a census on the 12th or 13th but does on the 14th. i want to be able to pull this pat_id and dates they are not stamped with census.
11-APR-2019 11:59:00 PM CENSUS
12-APR-2019 03:12:00 PM TRANSFER OUT
12-APR-2019 03:12:00 PM TRANSFER IN
14-APR-2019 07:06:00 AM PATIENT UPDATE
14-APR-2019 11:40:00 AM TRANSFER OUT
14-APR-2019 11:40:00 AM TRANSFER IN
14-APR-2019 11:59:00 PM CENSUS
I created a calendar portion to my query. then i created a query to capture patients in a time frame. from there i am a bit stuck.
DATE1
AS
(select
to_char(dates,'MM/DD/YYYY') AS WEEK_DATE,
dates,
to_char(dates,'D') weekday,
to_char(dates,'mm') m_onth,
to_char(dates,'ww') week_of_year,
to_char(dates,'dd') month_day,
to_char(dates,'ddd') Year_day,
SUBSTR(dates,1,2) AS WEEKDATE
from (SELECT TRUNC(to_date(v.yyyy,'YYYY'),'YY') +LEVEL - 1 DATES
FROM ( SELECT 2019 yyyy FROM dual ) v
CONNECT BY LEVEL < 366
)
)
,
ADT
AS (select distinct
adt.pat_id,
peh.y_mrn,
adt.DEPARTMENT_ID,
adp.department_name,
--peh.HOSP_ADMSN_TIME,
to_char(peh.HOSP_ADMSN_TIME,'MM/DD/YYYY') AS HOSP_ADMSN_TIME2,
--peh.HOSP_DISCH_TIME,
to_char(peh.HOSP_DISCH_TIME,'MM/DD/YYYY') AS HOSP_DISCH_TIME2,
adt.effective_time,
to_char(aDT.effective_time,'MM/DD/YYYY') AS EFFECT_DATE,
--LEAD(adt.effective_time) over (partition by ADT.pat_id order by ADT.pat_id, adt.effective_time) AS NEXT_EFF_DATE,
--CASE WHEN adt.event_type_c =6 THEN adt.effective_time END AS CENSUS_DATE,
et.title as event_type,
adt.event_type_c,
peh.ADT_PAT_CLASS_C,
Adt.event_subtype_c--,
--LAG(adt.effective_time) over (partition by ADT.pat_id order by ADT.pat_id, adt.effective_time) AS PREV_EFF_DATE
from
clarity_adt adt
left OUTER join
pat_enc_hsp peh
on
peh.pat_enc_csn_id = adt.pat_enc_csn_id
left outer join
clarity_dep adp
on adt.department_id = adp.department_id
left OUTER join
zc_event_type et
on adt.event_type_c = et.event_type_c
where
adt.effective_time between '08-apr-2019' and '15-apr-2019'
order by adt.effective_time
)
,
ADT2
AS
(
SELECT-- DISTINCT
D.WEEK_DATE,
A.HOSP_ADMSN_TIME2,
A.EFFECT_DATE,
A.PAT_ID,
CASE WHEN D.WEEK_DATE IS NOT NULL AND A.EFFECT_DATE IS NULL AND A.event_type <> 'CENSUS' THEN 1
WHEN D.WEEK_DATE IS NOT NULL AND A.EFFECT_DATE IS NULL AND A.event_type IS NULL THEN 1
WHEN D.WEEK_DATE IS NOT NULL AND A.EFFECT_DATE IS NOT NULL AND A.event_type <> 'CENSUS' THEN 1 ELSE 0
END AS NO_ADT_INFO,
A.event_type,
A.HOSP_DISCH_TIME2
FROM
DATE2 D
LEFT OUTER JOIN
ADT A
ON
D.WEEK_DATE = A.EFFECT_DATE
ORDER BY
D.WEEK_DATE)
i would like to end up with the patient id, the day of the week they have no census, the hosp admission & discharge dates
PAT_ID WEEK_DATE EVENT_TYPE HOSP_ADMSN_TIME HOSP_DISCH_TIME
ABCDEF 4/12/2019 NO CENSUS 4/10/2019 4/19/2019
ABCDEF 4/13/2019 NO CENSUS 4/10/2019 4/19/2019
GHIJK 4/8/2019 NO CENSUS 4/2/2019 4/12/2019
GHIJK 4/11/2019 NO CENSUS 4/2/2019 4/12/2019

Answer 1

Here is sample data for two patients:
events(pat_id, event_date, event_type) as (
select 'ABCD', to_date('2019-04-11 23:59', 'yyyy-mm-dd hh24:mi'), 'CENSUS' from dual union all
select 'ABCD', to_date('2019-04-12 15:12', 'yyyy-mm-dd hh24:mi'), 'TRANSFER OUT' from dual union all
select 'ABCD', to_date('2019-04-12 15:12', 'yyyy-mm-dd hh24:mi'), 'TRANSFER IN' from dual union all
select 'ABCD', to_date('2019-04-14 07:06', 'yyyy-mm-dd hh24:mi'), 'PATIENT UPDATE' from dual union all
select 'ABCD', to_date('2019-04-14 11:40', 'yyyy-mm-dd hh24:mi'), 'TRANSFER OUT' from dual union all
select 'ABCD', to_date('2019-04-14 11:40', 'yyyy-mm-dd hh24:mi'), 'TRANSFER IN' from dual union all
select 'ABCD', to_date('2019-04-14 23:59', 'yyyy-mm-dd hh24:mi'), 'CENSUS' from dual union all
select 'GHIJ', to_date('2019-05-17 23:59', 'yyyy-mm-dd hh24:mi'), 'CENSUS' from dual union all
select 'GHIJ', to_date('2019-05-19 23:59', 'yyyy-mm-dd hh24:mi'), 'CENSUS' from dual ),
peh(pat_id, hosp_admsn_time, hosp_disch_time) as (
select 'ABCD', date '2019-04-11', date '2019-04-14' from dual union all
select 'GHIJ', date '2019-05-17', date '2019-05-20' from dual ),
You can create recursive query generating days for each patient and check if there is CENSUS event for each of these days:
with cte(pat_id, num, adm, dis) as (
select pat_id, 0, hosp_admsn_time, hosp_disch_time from peh
union all
select pat_id, num + 1, adm, dis from cte where num < dis - adm)
select pat_id, day, 'NO CENSUS' info, adm, dis
from (select pat_id, adm + num day, adm, dis from cte) d
where not exists (
select 1
from events
where pat_id = d.pat_id and trunc(event_date) = d.day and event_type = 'CENSUS')
order by pat_id, day;
Result:
PAT_ID DAY INFO ADM DIS
------ ----------- --------- ----------- -----------
ABCD 2019-04-12 NO CENSUS 2019-04-11 2019-04-14
ABCD 2019-04-13 NO CENSUS 2019-04-11 2019-04-14
GHIJ 2019-05-18 NO CENSUS 2019-05-17 2019-05-20
GHIJ 2019-05-20 NO CENSUS 2019-05-17 2019-05-20
dbfiddle demo