Misdiagnosis and Quality of Management in Paediatric Surgical Patients Referred to a Tertiary Care Hospital TC01-TC05
Dr. Eduardo Bracho-Blanchet,
Faculty, Hospital Infantil de Mexico Federico Gomez, Tercer piso Oficina de Cirugia General, Dr. Marquez 162, Col. Doctores,
CP 06720 Mexico D.F.
Phone: +52-55-2128-0565, E-mail: email@example.com
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.