The Epidemiology of Diagnostic Error in Emergency Care in the United States and the Association with Patient Outcomes and Healthcare Costs

美国急诊护理诊断错误的流行病学及其与患者结果和医疗费用的关系

• 批准号: 10828982
• 负责人: Laura G Burke
• 金额: $ 50万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-30 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10828982
• 关键词: Epidemiology; Diagnostic; Error; Emergency; Care

Diagnostic error is thought to be common, costly, and associated with substantial patient harm in the United States (U.S.). A recent report by the Agency for Healthcare Research and Quality (AHRQ) highlighted the importance of addressing diagnostic error in emergency care and called for additional research examining contemporary diagnostic errors rates in U.S. emergency departments (EDs). ED visits are common, with 1 in 5 Americans visiting the ED, leading to over 130 million ED visits annually. Diagnostic accuracy for emergency conditions is essential for optimal patient outcomes. Yet, the very nature of the ED, including unpredictable patient volume, limited time and available information, as well as frequent interruptions, can make diagnostic accuracy in the ED challenging. While there has been substantial attention paid to the variation in the quality of emergency care, there has been relatively less research on diagnostic safety in the ED, as highlighted by the recent AHRQ report. This project will use representative national claims data to provide detailed evidence on the landscape of diagnostic error in U.S. EDs. We will quantify the rate of diagnostic error for high-risk emergency conditions as well as the common symptoms associated with these diseases. Additionally, we will examine the degree to which diagnostic error in emergency care is associated with patient harm. We will identify the patient, clinician, and hospital factors associated with greater risk of diagnostic error. Finally, we will examine if having an ambulatory follow-up visit after an ED diagnostic error can mitigate the harms associated with misdiagnosis. This national study will enable frontline clinicians and policymakers to understand the extent of diagnostic error in U.S. EDs and the factors that may be targeted for quality improvement efforts to address this important public health problem.

诊断错误被认为是常见，昂贵的，并且与大量患者伤害有关 在美国（美国）。医疗保健研究和质量机构的最新报告 （AHRQ）强调了解决紧急护理中诊断错误的重要性 有关在美国紧急情况下检查当代诊断误差率的其他研究 部门（eds）。 ED访问很常见，有五分之一的美国人访问ED，导致结束 每年1.3亿ED访问。紧急情况的诊断准确性对于 最佳患者预后。然而，急诊室的本质，包括不可预测的患者 数量，有限的时间和可用信息以及频繁的中断，可以使 ED挑战性的诊断准确性。虽然已经大大关注 紧急护理质量的差异，关于 最近的AHRQ报告强调了ED的诊断安全性。这个项目将使用 代表性的国家索赔数据提供有关诊断景观的详细证据 美国Eds的错误。我们将量化高风险紧急情况的诊断错误率 以及与这些疾病有关的常见症状。此外，我们将检查 紧急护理中诊断错误与患者伤害有关的程度。我们将 确定患者，临床医生和医院因素与更大的诊断错误风险相关。 最后，我们将检查在ED诊断错误之后是否进行门诊后续访问 减轻与误诊有关的危害。这项国家研究将使前线 临床医生和政策制定者了解美国EDS的诊断错误程度 可能针对质量改进工作的因素来解决这一重要公众 健康问题。