The Accuracy of Diagnoses of Referred Patients in a Regional Hospital System

摘要

The study explores the USAF Medical Service's regionalized hospital system and the accuracy of the diagnoses of referred pulmonary tuberculosis patients. The object of the study is to determine the variations in accuracy among the referring facilities and to ascertain if they are related to size and if so, to find possible causal factors. The findings indicate that a significant number of erroneously diagnosed patients do originate in small medical facilities. They also point up variations among the various patient categories. Non-military patients have a low accuracy rate in small hospitals and a high one in large facilities. Officers have a low rate in all facilities. The enlisted ranks fare the same in all facilities. The lack of diagnostic 'tools' at small hospitals was originally considered to be a possible reason for the errors in diagnosis. This was not conclusively proven to be the case. While there are minor variations in the use of diagnostic tests and procedures between the accurately diagnosed patients and the inaccurately diagnosed ones they are not strongly related to hospital size. The greater problem seems to be the use or interpretation of the test results. The most important causal factor in diagnostic accuracy seems to be the skill and experience of the diagnosing physician in the use and interpretation of the tools available to him. (Author)