Inpatient diagnostic errors

Powell, Melanie A Melanie.A.Powell at MEDSTAR.NET
Mon Aug 14 12:55:14 UTC 2017


"Compared with other paid claim types, physicians >50 years of age were 0.96 times more likely to have a diagnosis-related paid claim than those aged 20–49 (95% CI 0.93 to 0.99, p=0.010)."

This may or may not be clinically significant (the propensity may be towards getting sued rather than making more errors; the authors mention this) but it is definitely interesting, especially since the rate and cost of diagnostic error is increasing so much (31% increase in median payments between 2004 and 2016). Another interesting variable is region of practice (Northeast physicians 11% more likely to be successfully sued by plaintiffs than any other region).

This does not necessarily mean that younger physicians or those practicing in the Northeast make more errors (as mentioned in the study, they did not perform chart review or look at unpaid claims data) but they do pay more total dollar amount in legal claims (variables include legal environment, hospital policy re: disclosure of adverse events, etc.).

I would be interested to see a study reviewing diagnostic error using voluntary patient safety event reporting systems (also mentioned by the authors in discussion). Of course, this data set has its own limitations.

Melanie Powell, MD/MPH

________________________________
From: Robert Bell [0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG]
Sent: Sunday, August 13, 2017 11:21 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Inpatient diagnostic errors

Thanks Mark,

That is GOOD news. With my concern about stethoscopes I would like to see the effect of age on stethoscope accuracy.

Does this suggest that experience well compensates for other age related errors/mistakes. E.g. hearing loss, forgetfullness, poorer sight, etc?

Rob Bell, M.D.

Sent from my iPad

On Aug 13, 2017, at 6:17, Mark Graber <Mark.Graber at IMPROVEDIAGNOSIS.ORG<mailto:Mark.Graber at IMPROVEDIAGNOSIS.ORG>> wrote:

Thanks to Ashwin Gupta and colleagues for a detailed claims-based study of inpatient diagnostic error.  Incidentally, this is the first data I’ve seen suggesting that older physicians had fewer error-related claims; great news for us senior clinicians   ;<)

Malpractice claims related to diagnostic errors in the hospital
    Gupta, A., Snyder, A., Kachalia, A., Flanders, S., Saint, S., Chopra, V.
    BMJQS 2017 0: p. bmjqs-2017-006774v1-bmjqs-2017-006774

<https://urldefense.proofpoint.com/v2/url?u=http-3A__qualitysafety.bmj.com_cgi_content_abstract_bmjqs-2D2017-2D006774v1-3Fct&d=DwMFaQ&c=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=C42EOoK0usvan6uLAPOvpUNb_Jn8YFsH_X3utGQE6zc&m=sg5Sh036yaiecKJmUE0DqjO5XqvC4vZXLtC1qvA8Q_c&s=KtMrSk-qMRSvFPAr-iJ9jjyCR72LsoBGzizt4qxP438&e=>http://qualitysafety.bmj.com/cgi/content/abstract/bmjqs-2017-006774v1?ct<https://urldefense.proofpoint.com/v2/url?u=http-3A__qualitysafety.bmj.com_cgi_content_abstract_bmjqs-2D2017-2D006774v1-3Fct&d=DwMFaQ&c=RvBXVp2Kc-itN3g6r3sN0QK_zL4whPpndVxj8-bJ04M&r=C42EOoK0usvan6uLAPOvpUNb_Jn8YFsH_X3utGQE6zc&m=sg5Sh036yaiecKJmUE0DqjO5XqvC4vZXLtC1qvA8Q_c&s=KtMrSk-qMRSvFPAr-iJ9jjyCR72LsoBGzizt4qxP438&e=>



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