Files
onboard/app/Services/UnifiedPatientService.php
2026-05-06 22:32:11 +09:00

345 lines
12 KiB
PHP

<?php
namespace App\Services;
use App\Data\UnifiedPatientData;
use App\Infrastructure\Reports\Sources\MisPatientSource;
use App\Infrastructure\Reports\Sources\SpecialPatientSource;
use App\Models\Department;
use App\Models\DepartmentPatient;
use App\Models\MedicalHistory;
use App\Models\MisMedicalHistory;
use App\Models\ObservationPatient;
use App\Models\Report;
use App\Models\User;
use Illuminate\Support\Collection;
class UnifiedPatientService
{
private const SPECIAL_SOURCE_TYPES = ['manual', 'special'];
public function __construct(
protected PatientService $patientService,
?MisPatientSource $misPatientSource = null,
?SpecialPatientSource $specialPatientSource = null,
) {
$this->misPatientSource = $misPatientSource ?? app(MisPatientSource::class);
$this->specialPatientSource = $specialPatientSource ?? app(SpecialPatientSource::class);
}
protected MisPatientSource $misPatientSource;
protected SpecialPatientSource $specialPatientSource;
public function getLivePatientsByStatus(
Department $department,
User $user,
string $status,
DateRange $dateRange,
int $branchId,
bool $onlyIds = false,
?bool $includeCurrent = null,
bool $fillableAuto = false,
bool $forSnapshots = false
): Collection {
[$baseStatus, $sourceScope] = $this->parseScopedStatus($status);
if ($baseStatus === 'observation') {
return $this->getObservationPatients($department, $onlyIds, $sourceScope);
}
$patients = match ($sourceScope) {
'mis' => $this->misPatientSource->getDtos($user, $baseStatus, $dateRange, $branchId, $includeCurrent, $fillableAuto, $forSnapshots),
'special' => $this->specialPatientSource->getDtos($department, $baseStatus, $dateRange, self::SPECIAL_SOURCE_TYPES, $forSnapshots),
default => $this->getAggregatedPatientDtos($department, $user, $baseStatus, $dateRange, $branchId, $includeCurrent, $fillableAuto, $forSnapshots),
};
if ($onlyIds) {
return $patients->pluck('id');
}
return $patients;
}
public function getLivePatientCountByStatus(
Department $department,
User $user,
string $status,
DateRange $dateRange,
int $branchId,
?bool $includeCurrent = null,
bool $fillableAuto = false
): int {
[$baseStatus, $sourceScope] = $this->parseScopedStatus($status);
if ($baseStatus === 'observation') {
$query = ObservationPatient::query()
->where('rf_department_id', $department->department_id);
if ($sourceScope === 'special') {
return $query->whereNotNull('rf_department_patient_id')->count();
}
if ($sourceScope === 'mis') {
return $query->whereNull('rf_department_patient_id')->count();
}
return $query->count();
}
if ($sourceScope === 'special') {
return $this->specialPatientSource->getCount($department, $baseStatus, $dateRange, self::SPECIAL_SOURCE_TYPES);
}
$misCount = $this->misPatientSource->getCount(
$user,
$baseStatus,
$dateRange,
$branchId,
$includeCurrent,
$fillableAuto
);
if ($sourceScope === 'mis') {
return $misCount;
}
$specialCount = $this->specialPatientSource->getCount($department, $baseStatus, $dateRange, self::SPECIAL_SOURCE_TYPES);
return $misCount + $specialCount;
}
public function getRecipientIdsForReport(
Department $department,
User $user,
DateRange $dateRange,
int $branchId,
bool $fillableAuto = false
): array {
$isHeadOrAdmin = $user->isHeadOfDepartment() || $user->isAdmin();
$misIds = $this->patientService->getPlanOrEmergencyPatients(
null,
$isHeadOrAdmin,
$branchId,
$dateRange,
false,
true,
false,
$fillableAuto
);
$manualIds = $this->specialPatientSource->getPatients($department, 'recipient', $dateRange, self::SPECIAL_SOURCE_TYPES, false)
->whereBetween('admitted_at', [$dateRange->startSql(), $dateRange->endSql()])
->pluck('department_patient_id');
$misUids = collect($misIds)->map(fn ($id) => "mis:{$id}")->all();
$manualUids = collect($manualIds)->map(fn ($id) => "manual:{$id}")->all();
return array_values(array_unique(array_merge($misUids, $manualUids)));
}
public function createManualPatient(Department $department, User $user, array $data, int $reportId): DepartmentPatient
{
return DepartmentPatient::create([
'rf_department_id' => $department->department_id,
'rf_report_id' => $reportId,
'source_type' => 'special',
'full_name' => $data['full_name'],
'birth_date' => $data['birth_date'],
'patient_kind' => $data['patient_kind'],
'diagnosis_code' => $data['diagnosis_code'] ?? null,
'diagnosis_name' => $data['diagnosis_name'] ?? null,
'admitted_at' => $data['admitted_at'] ?? now(),
'is_current' => true,
'created_by' => $user->id,
]);
}
public function recordManualOutcome(DepartmentPatient $patient, array $data): DepartmentPatient
{
$patient->update([
'is_current' => false,
'outcome_type' => $data['outcome_type'],
'outcome_at' => $data['outcome_at'] ?? now(),
]);
return $patient->fresh();
}
public function updateManualPatient(DepartmentPatient $patient, array $data): DepartmentPatient
{
$manualStatus = $data['manual_status'] ?? null;
$isCurrent = $manualStatus === 'current' || $manualStatus === null;
$outcomeType = match ($manualStatus) {
'discharged', 'deceased', 'transferred' => $manualStatus,
default => null,
};
$patient->update([
'full_name' => $data['full_name'],
'birth_date' => $data['birth_date'],
'patient_kind' => $data['patient_kind'],
'diagnosis_code' => $data['diagnosis_code'] ?? null,
'diagnosis_name' => $data['diagnosis_name'] ?? null,
'admitted_at' => $data['admitted_at'] ?? $patient->admitted_at,
'is_current' => $isCurrent,
'outcome_type' => $outcomeType,
'outcome_at' => $isCurrent ? null : ($data['outcome_at'] ?? now()),
]);
return $patient->fresh();
}
public function linkManualPatientToMis(DepartmentPatient $patient, int $medicalHistoryId): DepartmentPatient
{
$history = MedicalHistory::query()
->where('original_id', $medicalHistoryId)
->firstOrFail();
$patient->update([
'rf_medicalhistory_id' => $history->original_id,
'linked_to_mis_at' => now(),
'full_name' => $patient->full_name ?: $history->full_name,
'birth_date' => $patient->birth_date ?: $history->birth_date,
]);
return $patient->fresh();
}
public function searchMisPatients(Department $department, string $query): Collection
{
return MedicalHistory::query()
->whereLike('full_name', "%{$query}%")
->whereHas('migrations', fn ($builder) => $builder->department($department->rf_mis_department_id))
->with(['latestMigration', 'operations'])
->limit(20)
->get()
->map(fn (MedicalHistory $patient) => UnifiedPatientData::fromMedicalHistory($patient));
}
public function getObservationPatients(
Department $department,
bool $onlyIds = false,
string $sourceScope = 'all'
): Collection {
$observationPatients = ObservationPatient::where('rf_department_id', $department->department_id)->get();
$misIds = $observationPatients->pluck('rf_medicalhistory_id')->filter()->unique()->values();
$manualIds = $observationPatients->pluck('rf_department_patient_id')->filter()->unique()->values();
$misPatients = MedicalHistory::query()
->whereIn('original_id', $misIds)
->with(['latestMigration', 'operations'])
->get()
->keyBy('original_id');
$manualPatients = DepartmentPatient::whereIn('department_patient_id', $manualIds)->get()->keyBy('department_patient_id');
$patients = $observationPatients->map(function (ObservationPatient $observation) use ($misPatients, $manualPatients, $sourceScope) {
if ($observation->rf_department_patient_id && $manualPatients->has($observation->rf_department_patient_id)) {
if ($sourceScope === 'mis') {
return null;
}
return UnifiedPatientData::fromDepartmentPatient(
$manualPatients[$observation->rf_department_patient_id],
false,
[],
$observation->comment
);
}
if ($observation->rf_medicalhistory_id && $misPatients->has($observation->rf_medicalhistory_id)) {
if ($sourceScope === 'special') {
return null;
}
return UnifiedPatientData::fromMedicalHistory(
$misPatients[$observation->rf_medicalhistory_id],
false,
null,
$observation->comment
);
}
return null;
})->filter()->values();
if ($onlyIds) {
return $patients->pluck('id');
}
return $patients;
}
private function getAggregatedPatientDtos(
Department $department,
User $user,
string $status,
DateRange $dateRange,
int $branchId,
?bool $includeCurrent = null,
bool $fillableAuto = false,
bool $forSnapshots = false
): Collection {
$misPatients = $this->misPatientSource->getPatients($user, $status, $dateRange, $branchId, $includeCurrent, $fillableAuto, $forSnapshots);
$linkedManualPatients = $this->specialPatientSource->getLinkedManualPatientsForPeriod($department, $dateRange);
$mergedMisPatients = $misPatients->map(function ($patient) use ($linkedManualPatients) {
$medicalHistoryId = $patient instanceof MedicalHistory
? ($patient->original_id ?? $patient->id)
: $patient->MedicalHistoryID;
$linkedManual = $linkedManualPatients->get($medicalHistoryId);
return $patient instanceof MedicalHistory
? UnifiedPatientData::fromMedicalHistory(
$patient,
(bool) ($patient->is_recipient_today ?? false),
$linkedManual,
$this->resolveObservationComment($medicalHistoryId, null)
)
: UnifiedPatientData::fromMisMedicalHistory(
$patient,
(bool) ($patient->is_recipient_today ?? false),
$linkedManual,
$this->resolveObservationComment($medicalHistoryId, null)
);
});
$manualDtos = $this->specialPatientSource->getDtos($department, $status, $dateRange, self::SPECIAL_SOURCE_TYPES, $forSnapshots);
return UnifiedPatientData::unique($mergedMisPatients->concat($manualDtos))
->sortByDesc(fn (UnifiedPatientData $patient) => $patient->admittedAt ?? '')
->values();
}
private function parseScopedStatus(string $status): array
{
foreach (['mis', 'special'] as $scope) {
$prefix = "{$scope}-";
if (str_starts_with($status, $prefix)) {
return [substr($status, strlen($prefix)), $scope];
}
}
return [$status, 'all'];
}
private function resolveObservationComment(?int $medicalHistoryId, ?int $departmentPatientId): ?string
{
$query = ObservationPatient::query();
if ($departmentPatientId) {
$query->where('rf_department_patient_id', $departmentPatientId);
} elseif ($medicalHistoryId) {
$query->where('rf_medicalhistory_id', $medicalHistoryId);
} else {
return null;
}
return $query->pluck('comment')->filter()->implode('; ') ?: null;
}
}