BACKGROUND: The literature on diagnosis and management prior to transfer paediatric surgical patients to a tertiary care center is scarce. In referral centers, it is common to receive patients previously subjected to inadequate or inappropriate health care. AIM: Analyze the prevalence of misdiagnosis and quality of management in patients before being referred and factors related to misdiagnosis and inadequate management. DESIGN: Prospective, longitudinal, comparative study between patients with appropriate and inappropriate submission diagnosis and between patients with adequate or inadequate treatment. SETTING: Third level care hospital, Mexico City. PARTICIPANTS: Newborn to adolescents referred to Paediatric Surgery Department. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Misdiagnosis and quality of management prior to being referred. RESULT: Two hundred patients were evaluated. Correlation between submission diagnosis and final diagnosis showed that 70% were correct and 30% incorrect; 48.5% were properly managed and 51.5% inappropriately managed. Incorrect diagnosis was more frequent when referred from first-or second-level hospitals and in inflammatory conditions. Patients referred by paediatricians had a higher rate of adequate management. CONCLUSION: We present the frequency of incorrect diagnosis and inadequate patient management in a highly selected population. Sample size should be increased as well as performing these studies in other hospital settings in order to determine whether the results are reproducible.
BACKGROUND: The literature on diagnosis and management prior to transfer paediatric surgical patients to a tertiary care center is scarce. In referral centers, it is common to receive patients previously subjected to inadequate or inappropriate health care. AIM: Analyze the prevalence of misdiagnosis and quality of management in patients before being referred and factors related to misdiagnosis and inadequate management. DESIGN: Prospective, longitudinal, comparative study between patients with appropriate and inappropriate submission diagnosis and between patients with adequate or inadequate treatment. SETTING: Third level care hospital, Mexico City. PARTICIPANTS: Newborn to adolescents referred to Paediatric Surgery Department. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Misdiagnosis and quality of management prior to being referred. RESULT: Two hundred patients were evaluated. Correlation between submission diagnosis and final diagnosis showed that 70% were correct and 30% incorrect; 48.5% were properly managed and 51.5% inappropriately managed. Incorrect diagnosis was more frequent when referred from first-or second-level hospitals and in inflammatory conditions. Patients referred by paediatricians had a higher rate of adequate management. CONCLUSION: We present the frequency of incorrect diagnosis and inadequate patient management in a highly selected population. Sample size should be increased as well as performing these studies in other hospital settings in order to determine whether the results are reproducible.
Entities:
Keywords:
Delayed diagnosis; Diagnostic errors; Health care; Patient care management
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