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| Content Provider | Taylor & Francis Online |
|---|---|
| Author | Tamondong-Lachica, Diana Shimkhada, Riti Solon, Orville Peabody, John W. |
| Abstract | BackgroundMisdiagnosis may be a significant and under-recognized quality of care problem. In birthing facilities located in anurban Philippine setting, we investigated the diagnostic accuracy for three obstetric conditions: cephalopelvic disproportion (CPD), post-partum hemorrhage (PPH), and pre-eclampsia.DesignIdentical simulated cases were used to measure diagnostic accuracy for every provider (n=103). We linked misdiagnosis – identified by the simulated cases – to obstetrical complications of the patients at the participating facilities. Patient-level data on health outcomes and costs were obtained from medical records and follow-home in-person interviews.ResultsThe prevalence of misdiagnosis among obstetric providers was 29.8% overall, 25% for CPD, 33% for PPH, and 31% for pre-eclampsia. Linking provider decision-making to patients, we found those who misdiagnosed the simulated cases were more likely to have patients with a complication (OR 2.96; 95% CI 1.39–3.77) compared with those who did not misdiagnose. Complicated patients were significantly less likely to be referred to a hospital immediately, were more likely to be readmitted to a hospital after delivery, had significantly higher medical costs, and lost more income than non-complicated patients.ConclusionDiagnosis is arguably the most important task a clinician performs because it determines the subsequent course of evaluation and treatment, with the direct and indirect costs of diagnostic error, placing large financial burdens on the patient. |
| File Format | PDF HTM / HTML |
| ISSN | 16549716 16549880 |
| DOI | 10.3402/gha.v9.32672 |
| Journal | Global Health Action |
| Volume Number | 9 |
| Issue Number | 1 |
| Language | English |
| Publisher | Taylor & Francis |
| Publisher Date | 2016-12-15 |
| Access Restriction | Open |
| Subject Keyword | Misdiagnosis Health outcomes Health costs Philippines Quality of care Practice variability Obstetrics |
| Content Type | Text |
| Resource Type | Article |
| Subject | Public Health, Environmental and Occupational Health Health Policy |
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