Diagnostic packages can be assigned accurately in emergency departments. A multi-centre cohort study.
BACKGROUND
In the Region of Southern Denmark, the emergency departments categorise patients based on presenting symptoms and a proposed diagnostic package (n = 40) within each category. The diagnostic packages describe relevant clinical information and standard laboratory and other investigations to be performed. Allocation to the right diagnostic package is assumed to be associated with a higher quality. The aim of this study was to describe to which degree the assigned symptom-based diagnostic packages are related to relevant discharge diagnoses.


METHODS
This was a descriptive cohort study. The analysis was based on data on assigned diagnostic package, patient discharge diagnosis, hospital, gender, age, time of admission and discharge, length of stay, diagnostic package assigned, discharge diagnosis and co-morbidity. An acceptable standard for what would be an appropriate primarily diagnostic package was developed using a modified Delphi method.


RESULTS
A total of 16,543 patient contacts were identified. Women constituted 52.2% (n = 8,925) of the patients. The median age was 64 years and the median length of stay was one day. All diagnostic packages were represented. A total of 68% of the included patients had been assigned an acceptable diagnostic package (95% confidence interval: 67.2-68.7). We found an appropriate use of one of 30 diagnostic packages in more than 50% of the cases.


CONCLUSIONS
We found that 68% of the included patients were assigned an acceptable diagnostic package and that about 80% of all acute pathways were covered by 14 diagnostic packages.


BACKGROUND
The study was funded by Region of Southern Denmark.


BACKGROUND
The study was registered with the Danish Data Protection Agency (No. 2008-58-0035). No further approval was required.
binorgaard@health.sdu.dk.
Birgitte
B
Nørgaard
Christian Backer
CB
Mogensen
Lars Stubbe
LS
Teglbjærg
Mikkel
M
Brabrand
Annmarie Touborg
AT
Lassen
D000368:Aged; D015331:Cohort Studies; D003695:Delivery of Health Care / Q000379:methods; D003718:Denmark; D003953:Diagnosis-Related Groups; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010351:Patient Discharge / Q000706:statistics & numerical data*