FP06 A STUDY OF DIAGNOSIS DISCREPANCY BETWEEN ADMISSION AND DISCHARGE IN HOSPITAL UNIVERSITI SAINS MALAYSIA.

Abstract

Introduction: The accuracy of Emergency Department (ED) in making a provisional diagnosis is crucial as it has direct impact on the patient treatment, safety, length of stay and cost of treatment. The study of the accuracy of the provisional diagnosis made by ED to compare with the discharge diagnosis is scarce in its availability and most results vary with different continents. This study was conducted to evaluate the accuracy of the diagnosis made by ED in Hospital Universiti Sains Malaysia (HUSM) and the factors contributed to the discrepancy.

Methods: This was a retrospective cross-sectional study in which medical records of patient admitted to HUSM within Mei 2016 until December 2017 were selected using simple random sampling methods. The folders were then reviewed and the association within the categorized diagnosis accuracy was analysed using the ICD-10 classification. The sample size was 180 cases and the accuracy of the diagnosis was divided into two main categories. The factors associated with the unmatched diagnosis from both, patients and provider were then measured using multiple logistic regressions.

Results: HUSM Emergency department had 84.4 percent of matched diagnosis with 15.56 percent of unmatched diagnosis. As the age of patient was younger by a year, we noted the probability of making unmatched diagnosis increased by two percent. No provider factors were noted to be associated with increase of the incident of unmatched diagnosis.

Conclusions: HUSM Emergency department had a low diagnostic discrepancy as compared to the discharge diagnosis.