A Study on the Diagnostic Discrepancy between Admission and  Discharge in Hospital Universiti Sains Malaysia

Mohd Syafwan Adnan; Kamarul Aryffin Baharuddin; Jamilah Al-muhammady Mohammad; Mohd Boniami Yazid; Mohammad Zikri Ahmad

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A Study on the Diagnostic Discrepancy between Admission and Discharge in Hospital Universiti Sains Malaysia

Author: Mohd Syafwan Adnan ¹ ; Kamarul Aryffin Baharuddin ^{2
,

3} ; Jamilah Al-Muhammady Mohammad ⁴ ; Mohd Boniami Yazid ^{2
,

3} ; Mohammad Zikri Ahmad ^{2
,

3}
Author Information

1. Emergency and Trauma Department, International Islamic University Malaysia Medical Centre (IIUMMC), Jalan Sultan Ahmad Shah, 25200 Kuantan, Pahang, Malaysia
2. Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia&
3. Department of Emergency Medicine, Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, 16150 Kubang Kerian, Kelantan, Malaysia
4. Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
Publication Type:Journal Article
Keywords: Diagnostic discrepancy, Diagnosis, Emergency department, Patient safety
From:Malaysian Journal of Medicine and Health Sciences 2021;17(No.1):105-110
CountryMalaysia
Language:English
Abstract: Introduction: Accurate provisional diagnosis in the Emergency Department (ED) is important as it has a significant impact on safety. It also affects the patients’ treatment, length of stay and cost of treatment. The data on the accuracy of making diagnosis made by ED doctors is scarce and most results vary with different countries. This study was conducted to evaluate the accuracy of the diagnosis made by the ED doctors in Hospital Universiti Sains Malaysia (USM) and the factors contributed to the discrepancy. Method: This was a retrospective cross-sectional study conducted in Hospital USM from May 2016 to December 2017. Medical records of the patients who were admitted to the hospital were selected using simple random sampling methods. The folders were reviewed and the association within the categorised diagnosis accuracy was analysed using the ICD-10 classification. The sample size was 180 cases, and cases were 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: Hospital USM Emergency Department had 15.6 per cent of unmatched diagnosis and 84.4 per cent of matched diagnosis. No difference between age and gender in making accurate diagnosis. The odds of having unmatched diagnosis in patients from the green zone are 4.2 times higher compared to the red zone. Conclusion: ED Hospital USM has a high diagnostic accuracy, especially involving the patients in red zone and yellow zone.
Full text:11.2021my0996.pdf