onboard/app/Services/PatientService.php

<?php

namespace App\Services;

use App\Models\MisMedicalHistory;
use App\Models\MisMigrationPatient;
use App\Models\MisReanimation;
use App\Models\MisSurgicalOperation;
use App\Models\ObservationPatient;

class PatientService
{
    public function __construct(
        protected OutcomePatientService $outcomePatientService,
        protected RecipientPatientService $recipientPatientService,
        protected CurrentPatientService $currentPatientService
    )
    { }

    /**
     * Получить плановых или экстренных пациентов
     */
    public function getPlanOrEmergencyPatients(
        ?string $type,
        bool $isHeadOrAdmin,
        int $branchId,
        DateRange $dateRange,
        bool $countOnly = false,
        bool $onlyIds = false,
        bool $includeCurrent = false,
        bool $fillableAuto = false
    ) {
        $medicalHistoryIds = $this->recipientPatientService->resolvePlanOrEmergencyMedicalHistoryIds(
            $type,
            $isHeadOrAdmin,
            $branchId,
            $dateRange,
            $includeCurrent,
            $fillableAuto
        );

        if (empty($medicalHistoryIds)) {
            return $countOnly ? 0 : collect();
        }

        if ($countOnly) {
            return count($medicalHistoryIds);
        }

        if ($onlyIds) {
            return collect($medicalHistoryIds);
        }

        $recipientIds = $this->recipientPatientService->getRecipientMedicalHistoryIds(
            $type,
            $isHeadOrAdmin,
            $branchId,
            $dateRange
        );

        $res = $this->buildPatientCardsQuery($medicalHistoryIds, $branchId);

        return $res->get()
            ->map(function ($patient) use ($recipientIds) {
                $patient->is_recipient_today = in_array($patient->MedicalHistoryID, $recipientIds, true);
                return $patient;
            });

    }

    /**
     * Получить всех пациентов в отделении (поступившие сегодня + уже лечащиеся)
     */
    public function getAllPatientsInDepartment(
        bool $isHeadOrAdmin,
        int $branchId,
        DateRange $dateRange,
        bool $countOnly = false,
        bool $onlyIds = false,
        bool $fillableAuto = false
    ) {
        $recipientIds = $this->recipientPatientService->buildRecipientQuery(null, $isHeadOrAdmin, $branchId, $dateRange, $fillableAuto)
            ->pluck('rf_MedicalHistoryID')
            ->toArray();

        if ($fillableAuto) {
            $currentIds = $this->currentPatientService->getHistoricalCurrentMedicalHistoryIds(null, $branchId, $dateRange);
        } else {
            $currentIds = MisMigrationPatient::currentlyInTreatment($branchId)
                ->pluck('rf_MedicalHistoryID')
                ->toArray();
        }

        $allIds = array_unique(array_merge($recipientIds, $currentIds));

        if (empty($allIds)) {
            if ($countOnly) return 0;
            return collect();
        }

        if ($countOnly) {
            return count($allIds);
        }

        if ($onlyIds) {
            return collect($allIds);
        }

        $res = MisMedicalHistory::whereIn('MedicalHistoryID', $allIds)
            ->select([
                'MedicalHistoryID',
                'FAMILY',
                'Name',
                'OT',
                'BD',
                'DateRecipient',
                'DateExtract',
                'rf_EmerSignID',
                'rf_kl_VisitResultID',
            ])
            ->with([
                'surgicalOperations' => function ($q) {
                    $q->select([
                        'SurgicalOperationID',
                        'rf_MedicalHistoryID',
                        'rf_kl_ServiceMedicalID',
                        'Date',
                    ])->with(['serviceMedical' => function ($serviceQuery) {
                        $serviceQuery->select([
                            'ServiceMedicalID',
                            'ServiceMedicalCode',
                            'ServiceMedicalName',
                        ]);
                    }]);
                },
                'outcomeMigration' => function ($q) {
                    $q->select([
                        'stt_migrationpatient.MigrationPatientID',
                        'stt_migrationpatient.rf_MedicalHistoryID',
                        'stt_migrationpatient.DateOut',
                        'stt_migrationpatient.rf_DiagnosID',
                    ])->with(['mainDiagnosis' => function ($diagnosisQuery) {
                        $diagnosisQuery->select([
                            'DiagnosID',
                            'rf_MKBID',
                        ])->with(['mkb' => function ($mkbQuery) {
                            $mkbQuery->select([
                                'MKBID',
                                'DS',
                                'NAME',
                            ]);
                        }]);
                    }]);
                },
                'migrations' => function ($q) use ($branchId) {
                    $q->where('rf_StationarBranchID', $branchId)
                        ->select([
                            'MigrationPatientID',
                            'rf_MedicalHistoryID',
                            'rf_DiagnosID',
                            'DateIngoing',
                            'rf_StationarBranchID',
                        ])
                        ->orderByDesc('DateIngoing')
                        ->with(['mainDiagnosis' => function ($diagnosisQuery) {
                            $diagnosisQuery->select([
                                'DiagnosID',
                                'rf_MKBID',
                                'rf_MigrationPatientID',
                            ])->with(['mkb' => function ($mkbQuery) {
                                $mkbQuery->select([
                                    'MKBID',
                                    'DS',
                                    'NAME',
                                ]);
                            }]);
                        }]);
                },
            ])
            ->orderBy('DateRecipient', 'DESC');

            return $res->get()
                ->map(function ($patient) use ($recipientIds) {
                    $patient->is_recipient_today = in_array($patient->MedicalHistoryID, $recipientIds);
                    return $patient;
            });
    }

    /**
     * Получить пациентов под наблюдением
     */
    public function getObservationPatients(int $departmentId, bool $onlyIds = false)
    {
        $query = MisMedicalHistory::whereHas('observationPatient', function ($q) use ($departmentId) {
            $q->where('rf_department_id', $departmentId);
        });

        if (!$onlyIds) {
            $query->with(['observationPatient' => function ($query) use ($departmentId) {
                $query->where('rf_department_id', $departmentId)
                    ->select(['rf_medicalhistory_id', 'observation_patient_id', 'comment']);
            }])
                ->orderBy('DateRecipient', 'DESC');
        }

        if ($onlyIds) $patients = $query->pluck('MedicalHistoryID');
        else {
            $query->with([
                'outcomeMigration.mainDiagnosis.mkb',
            ]);
            $patients = $query->get();
        }

        return $patients->map(function ($patient) {
            $patient->comment = $patient->observationPatient
                ->pluck('comment')
                ->filter()
                ->implode('; ');
            return $patient;
        });
    }

    /**
     * Получить выбывших пациентов
     */
    public function getOutcomePatients(
        int $branchId,
        DateRange $dateRange,
        string $outcomeType = 'all',
        bool $onlyIds = false
    ) {
        return $this->outcomePatientService->getOutcomePatients($branchId, $dateRange, $outcomeType, $onlyIds);
    }

    /**
     * Получить пациентов, находящихся в реанимации на конец периода
     */
    public function getReanimationPatients(
        int $branchId,
        DateRange $dateRange,
        bool $onlyIds = false
    ) {
        $medicalHistoryIds = MisReanimation::query()
            ->join('stt_migrationpatient as mp', 'mp.MigrationPatientID', '=', 'stt_reanimation.rf_MigrationPatientID')
            ->where('stt_reanimation.rf_StationarBranchID', $branchId)
            ->where('mp.rf_StationarBranchID', $branchId)
            ->where('mp.rf_MedicalHistoryID', '<>', 0)
            ->where('stt_reanimation.DateIn', '<=', $dateRange->endSql())
            ->where(function ($query) use ($dateRange) {
                $query->where('stt_reanimation.DateOut', '>=', $dateRange->endSql())
                    ->orWhereNull('stt_reanimation.DateOut')
                    ->orWhereDate('stt_reanimation.DateOut', '1900-01-01')
                    ->orWhereDate('stt_reanimation.DateOut', '2222-01-01');
            })
            ->distinct()
            ->pluck('mp.rf_MedicalHistoryID')
            ->toArray();

        if (empty($medicalHistoryIds)) {
            return collect();
        }

        if ($onlyIds) {
            return collect($medicalHistoryIds);
        }

        return MisMedicalHistory::whereIn('MedicalHistoryID', $medicalHistoryIds)
            ->select([
                'MedicalHistoryID',
                'FAMILY',
                'Name',
                'OT',
                'BD',
                'DateRecipient',
                'DateExtract',
                'rf_EmerSignID',
                'rf_kl_VisitResultID',
            ])
            ->with([
                'surgicalOperations' => function ($q) {
                    $q->select([
                        'SurgicalOperationID',
                        'rf_MedicalHistoryID',
                        'rf_kl_ServiceMedicalID',
                        'Date',
                    ])->with(['serviceMedical' => function ($serviceQuery) {
                        $serviceQuery->select([
                            'ServiceMedicalID',
                            'ServiceMedicalCode',
                            'ServiceMedicalName',
                        ]);
                    }]);
                },
                'outcomeMigration' => function ($q) {
                    $q->select([
                        'stt_migrationpatient.MigrationPatientID',
                        'stt_migrationpatient.rf_MedicalHistoryID',
                        'stt_migrationpatient.DateOut',
                        'stt_migrationpatient.rf_DiagnosID',
                    ])->with(['mainDiagnosis' => function ($diagnosisQuery) {
                        $diagnosisQuery->select([
                            'DiagnosID',
                            'rf_MKBID',
                        ])->with(['mkb' => function ($mkbQuery) {
                            $mkbQuery->select([
                                'MKBID',
                                'DS',
                                'NAME',
                            ]);
                        }]);
                    }]);
                },
            ])
            ->orderBy('DateRecipient', 'DESC')
            ->get();
    }

    /**
     * Получить пациентов с операциями
     */
    public function getSurgicalPatients(
        string $type,
        int $branchId,
        DateRange $dateRange,
        bool $countOnly = false
    ) {
        $query = MisSurgicalOperation::where('rf_StationarBranchID', $branchId)
                ->completed()
                ->where('Date', '>=', $dateRange->startSql())
                ->where('Date', '<=', $dateRange->endSql());

        if ($type === 'plan') {
            $query->where('rf_TypeSurgOperationInTimeID', 6);
        } else {
            $query->whereIn('rf_TypeSurgOperationInTimeID', [4, 5]);
        }

        if ($countOnly) {
            return $query->count();
        }

        return $query->get();
    }

    /**
     * Получить количество пациентов по типу с учетом уже находящихся в отделении
     */
    public function getPatientsCountWithCurrent(
        ?string $type,
        bool $isHeadOrAdmin,
        int $branchId,
        DateRange $dateRange
    ): int {
        return $this->getPlanOrEmergencyPatients(
            $type,
            $isHeadOrAdmin,
            $branchId,
            $dateRange,
            true,
            false,
            true
        );
    }

    private function buildPatientCardsQuery(array $medicalHistoryIds, int $branchId)
    {
        return MisMedicalHistory::query()
            ->whereIn('MedicalHistoryID', $medicalHistoryIds)
            ->select([
                'MedicalHistoryID',
                'FAMILY',
                'Name',
                'OT',
                'BD',
                'DateRecipient',
                'DateExtract',
                'DateDeath',
                'rf_EmerSignID',
                'rf_kl_VisitResultID',
            ])
            ->with([
                'surgicalOperations' => function ($q) {
                    $q->select([
                        'SurgicalOperationID',
                        'rf_MedicalHistoryID',
                        'rf_kl_ServiceMedicalID',
                        'Date',
                    ])->with(['serviceMedical' => function ($serviceQuery) {
                        $serviceQuery->select([
                            'ServiceMedicalID',
                            'ServiceMedicalCode',
                            'ServiceMedicalName',
                        ]);
                    }]);
                },
                'outcomeMigration' => function ($q) {
                    $q->select([
                        'stt_migrationpatient.MigrationPatientID',
                        'stt_migrationpatient.rf_MedicalHistoryID',
                        'stt_migrationpatient.DateOut',
                        'stt_migrationpatient.rf_DiagnosID',
                    ])->with(['mainDiagnosis' => function ($diagnosisQuery) {
                        $diagnosisQuery->select([
                            'DiagnosID',
                            'rf_MKBID',
                        ])->with(['mkb' => function ($mkbQuery) {
                            $mkbQuery->select([
                                'MKBID',
                                'DS',
                                'NAME',
                            ]);
                        }]);
                    }]);
                },
                'migrations' => function ($q) use ($branchId) {
                    $q->where('rf_StationarBranchID', $branchId)
                        ->select([
                            'MigrationPatientID',
                            'rf_MedicalHistoryID',
                            'rf_DiagnosID',
                            'DateIngoing',
                            'rf_StationarBranchID',
                        ])
                        ->orderByDesc('DateIngoing')
                        ->with(['mainDiagnosis' => function ($diagnosisQuery) {
                            $diagnosisQuery->select([
                                'DiagnosID',
                                'rf_MKBID',
                                'rf_MigrationPatientID',
                            ])->with(['mkb' => function ($mkbQuery) {
                                $mkbQuery->select([
                                    'MKBID',
                                    'DS',
                                    'NAME',
                                ]);
                            }]);
                        }]);
                },
            ])
            ->orderBy('DateRecipient', 'DESC');
    }
}