401 lines
14 KiB
PHP
401 lines
14 KiB
PHP
<?php
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namespace App\Services;
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use App\Models\LifeMisMigrationPatient;
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use App\Models\MisMedicalHistory;
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use App\Models\MisMigrationPatient;
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use App\Models\MisSurgicalOperation;
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use App\Models\ObservationPatient;
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use Carbon\Carbon;
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class PatientService
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{
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/**
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* Получить плановых или экстренных пациентов
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*/
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public function getPlanOrEmergencyPatients(
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?string $type,
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bool $isHeadOrAdmin,
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int $branchId,
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DateRange $dateRange,
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bool $countOnly = false,
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bool $onlyIds = false,
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bool $includeCurrent = false,
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bool $fillableAuto = false
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) {
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// Получаем поступивших сегодня
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$recipientQuery = $this->buildRecipientQuery($type, $isHeadOrAdmin, $branchId, $dateRange, $fillableAuto);
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if ($fillableAuto)
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$recipientIds = $recipientQuery->distinct()->pluck('rf_MedicalHistoryID')->toArray();
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else
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$recipientIds = $recipientQuery->pluck('rf_MedicalHistoryID')->toArray();
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// Если нужно добавить уже находящихся в отделении
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if ($includeCurrent) {
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if ($fillableAuto) {
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$currentIds = LifeMisMigrationPatient::currentlyInTreatment($branchId, $dateRange)
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->distinct()
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->pluck('rf_MedicalHistoryID')
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->toArray();
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} else {
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$currentIds = MisMigrationPatient::currentlyInTreatment($branchId)
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->pluck('rf_MedicalHistoryID')
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->toArray();
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}
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$medicalHistoryIds = array_unique(array_merge($recipientIds, $currentIds));
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} else {
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$medicalHistoryIds = $recipientIds;
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}
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if (empty($medicalHistoryIds)) {
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if ($countOnly) return 0;
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if ($onlyIds) return collect();
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return collect();
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}
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// Получаем истории
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$query = MisMedicalHistory::whereIn('MedicalHistoryID', $medicalHistoryIds)
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->with([
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'surgicalOperations' => function ($q) use ($dateRange) {
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$q->whereBetween('Date', [$dateRange->startSql(), $dateRange->endSql()]);
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},
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'migrations' => function ($q) use ($branchId) {
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$q->where('rf_StationarBranchID', $branchId)
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->take(1) // берем только одну последнюю
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->with(['diagnosis' => function ($q) {
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$q->where('rf_DiagnosTypeID', 3)
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->take(1)
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->with('mkb');
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}]);
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}
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])
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->orderBy('DateRecipient', 'DESC');
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// Фильтруем по типу (план/экстренные)
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if ($type === 'plan') {
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$query->plan();
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} elseif ($type === 'emergency') {
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$query->emergency();
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}
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if ($countOnly) {
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return $query->count();
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}
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if ($onlyIds) {
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return $query->pluck('MedicalHistoryID');
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}
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return $query->get()->map(function ($patient) use ($recipientIds, $branchId) {
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// Добавляем флаг "поступил сегодня"
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$patient->is_recipient_today = in_array($patient->MedicalHistoryID, $recipientIds);
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return $patient;
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});
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}
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/**
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* Получить всех пациентов в отделении (поступившие сегодня + уже лечащиеся)
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*/
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public function getAllPatientsInDepartment(
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bool $isHeadOrAdmin,
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int $branchId,
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DateRange $dateRange,
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bool $countOnly = false,
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bool $onlyIds = false
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) {
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// Поступившие сегодня
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$recipientIds = $this->buildRecipientQuery(null, $isHeadOrAdmin, $branchId, $dateRange)
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->pluck('rf_MedicalHistoryID')
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->toArray();
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// Уже находящиеся на лечении
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$currentIds = MisMigrationPatient::currentlyInTreatment($branchId)
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->pluck('rf_MedicalHistoryID')
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->toArray();
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// Объединяем и убираем дубли
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$allIds = array_unique(array_merge($recipientIds, $currentIds));
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if (empty($allIds)) {
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if ($countOnly) return 0;
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return collect();
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}
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if ($countOnly) {
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return count($allIds);
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}
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if ($onlyIds) {
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return collect($allIds);
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}
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return MisMedicalHistory::whereIn('MedicalHistoryID', $allIds)
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->with(['surgicalOperations' => function ($q) use ($dateRange) {
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$q->whereBetween('Date', [$dateRange->startSql(), $dateRange->endSql()]);
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}])
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->orderBy('DateRecipient', 'DESC')
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->get()
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->map(function ($patient) use ($recipientIds) {
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$patient->is_recipient_today = in_array($patient->MedicalHistoryID, $recipientIds);
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return $patient;
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});
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}
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/**
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* Получить пациентов под наблюдением
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*/
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public function getObservationPatients(int $departmentId, bool $onlyIds = false)
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{
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$query = MisMedicalHistory::whereHas('observationPatient', function ($q) use ($departmentId) {
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$q->where('rf_department_id', $departmentId);
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});
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if (!$onlyIds) {
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$query->with(['observationPatient' => function ($query) use ($departmentId) {
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$query->where('rf_department_id', $departmentId)
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->select(['rf_medicalhistory_id', 'observation_patient_id', 'comment']);
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}])
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->orderBy('DateRecipient', 'DESC');
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}
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if ($onlyIds) $patients = $query->pluck('MedicalHistoryID');
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else $patients = $query->get();
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return $patients->map(function ($patient) {
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$patient->comment = $patient->observationPatient
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->pluck('comment')
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->filter()
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->implode('; ');
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return $patient;
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});
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}
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/**
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* Получить выбывших пациентов
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*/
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public function getOutcomePatients(
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int $branchId,
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DateRange $dateRange,
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string $outcomeType = 'all',
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bool $onlyIds = false
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) {
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$methodMap = [
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'discharged' => 'outcomeDischarged',
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'transferred' => 'outcomeTransferred',
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'without-transferred' => 'outcomeWithoutTransferred',
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'deceased' => 'deceasedOutcome',
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'all' => 'outcomePatients',
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];
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$method = $methodMap[$outcomeType] ?? 'outcomePatients';
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$medicalHistoryIds = MisMigrationPatient::{$method}($branchId, $dateRange)
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->pluck('rf_MedicalHistoryID')
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->unique()
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->toArray();
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if (empty($medicalHistoryIds)) {
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return collect();
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}
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if ($onlyIds) return collect($medicalHistoryIds);
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return MisMedicalHistory::whereIn('MedicalHistoryID', $medicalHistoryIds)
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->with(['surgicalOperations'])
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->orderBy('DateRecipient', 'DESC')
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->get()
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->map(function ($patient) {
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return $this->addOutcomeInfo($patient);
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});
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}
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/**
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* Получить пациентов с операциями
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*/
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public function getSurgicalPatients(
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string $type,
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int $branchId,
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DateRange $dateRange,
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bool $countOnly = false
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) {
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$query = MisSurgicalOperation::where('rf_StationarBranchID', $branchId)
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->whereBetween('Date', [$dateRange->startSql(), $dateRange->endSql()]);
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if ($type === 'plan') {
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$query->where('rf_TypeSurgOperationInTimeID', 6);
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} else {
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$query->whereIn('rf_TypeSurgOperationInTimeID', [4, 5]);
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}
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if ($countOnly) {
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return $query->count();
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}
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return $query->get();
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}
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/**
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* Получить текущих пациентов
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*/
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public function getCurrentPatients(int $branchId, bool $countOnly = false)
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{
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$medicalHistoryIds = MisMigrationPatient::currentlyInTreatment($branchId)
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->pluck('rf_MedicalHistoryID')
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->unique()
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->toArray();
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if (empty($medicalHistoryIds)) {
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return $countOnly ? 0 : collect();
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}
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$query = MisMedicalHistory::whereIn('MedicalHistoryID', $medicalHistoryIds)
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->currentlyHospitalized()
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->with(['surgicalOperations'])
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->orderBy('DateRecipient', 'DESC');
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if ($countOnly) {
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return $query->count();
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}
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return $query->get();
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}
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/**
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* Собрать базовый запрос для пациентов
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*/
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private function buildPatientQuery(
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?string $type,
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bool $isHeadOrAdmin,
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int $branchId,
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DateRange $dateRange
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) {
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if ($isHeadOrAdmin) {
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$query = MisMigrationPatient::whereInDepartment($branchId)
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->whereBetween('DateIngoing', [$dateRange->startSql(), $dateRange->endSql()]);
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} else {
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$query = MisMigrationPatient::currentlyInTreatment($branchId)
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->whereBetween('DateIngoing', [$dateRange->startSql(), $dateRange->endSql()]);
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}
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$medicalHistoryIds = $query->pluck('rf_MedicalHistoryID')->toArray();
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if (empty($medicalHistoryIds)) {
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return MisMedicalHistory::whereRaw('1 = 0');
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}
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$query = MisMedicalHistory::whereIn('MedicalHistoryID', $medicalHistoryIds);
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if ($type === 'plan') {
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$query->plan();
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} elseif ($type === 'emergency') {
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$query->emergency();
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}
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if (!$isHeadOrAdmin && !in_array($type, ['discharged', 'transferred', 'deceased'])) {
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$query->currentlyHospitalized();
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}
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return $query;
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}
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/**
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* Построить запрос для поступивших пациентов
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*/
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private function buildRecipientQuery(
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?string $type,
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bool $isHeadOrAdmin,
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int $branchId,
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DateRange $dateRange,
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bool $fillableAuto = false
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) {
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// Разная логика для заведующего и врача
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if ($isHeadOrAdmin) {
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// Заведующий: все поступившие за период
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if ($fillableAuto) {
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$query = LifeMisMigrationPatient::whereInDepartment($branchId)
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->whereBetween('DateIngoing', [$dateRange->startSql(), $dateRange->endSql()]);
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} else {
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$query = MisMigrationPatient::whereInDepartment($branchId)
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->whereBetween('DateIngoing', [$dateRange->startSql(), $dateRange->endSql()]);
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}
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} else {
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// Врач: только поступившие за сутки
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if ($fillableAuto) {
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$query = LifeMisMigrationPatient::whereInDepartment($branchId)
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->whereBetween('DateIngoing', [$dateRange->startSql(), $dateRange->endSql()]);
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} else {
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$query = MisMigrationPatient::whereInDepartment($branchId)
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->whereBetween('DateIngoing', [$dateRange->startSql(), $dateRange->endSql()]);
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};
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}
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return $query;
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}
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/**
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* Добавить информацию об исходе пациенту
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*/
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private function addOutcomeInfo(MisMedicalHistory $patient)
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{
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$latestMigration = $patient->migrations
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->whereNotNull('DateOut')
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->where('DateOut', '<>', '1900-01-01')
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->sortByDesc('DateOut')
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->first();
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if ($latestMigration) {
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$patient->outcome_type = $this->getOutcomeTypeName($latestMigration->rf_kl_VisitResultID);
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$patient->outcome_date = $latestMigration->DateOut;
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$patient->visit_result_id = $latestMigration->rf_kl_VisitResultID;
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}
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return $patient;
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}
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/**
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* Получить количество пациентов по типу с учетом уже находящихся в отделении
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*/
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public function getPatientsCountWithCurrent(
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?string $type,
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bool $isHeadOrAdmin,
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int $branchId,
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DateRange $dateRange
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): int {
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// Поступившие сегодня указанного типа
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$recipientCount = $this->buildRecipientQuery($type, $isHeadOrAdmin, $branchId, $dateRange)
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->count();
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// Если нужны плановые/экстренные среди уже лечащихся
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$currentCount = 0;
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if ($type === 'plan' || $type === 'emergency') {
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$currentIds = MisMigrationPatient::currentlyInTreatment($branchId)
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->pluck('rf_MedicalHistoryID')
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->toArray();
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if (!empty($currentIds)) {
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$currentCount = MisMedicalHistory::whereIn('MedicalHistoryID', $currentIds)
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->when($type === 'plan', fn($q) => $q->plan())
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->when($type === 'emergency', fn($q) => $q->emergency())
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->count();
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}
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}
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return $currentCount;
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}
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/**
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* Получить название типа исхода
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*/
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private function getOutcomeTypeName(int $visitResultId): string
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{
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return match($visitResultId) {
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1, 7, 8, 9, 10, 11, 48, 49, 124 => 'Выписка',
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2, 3, 4, 12, 13, 14 => 'Перевод',
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5, 6, 15, 16 => 'Умер',
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default => 'Другое (' . $visitResultId . ')'
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};
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}
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}
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