Researchers Look at Diagnostic Discordance Among Hospitals

Find that 85% of patients transferred from one hospital to another wind up with a different set of diagnoses.

One of the byproducts of the many hospital mergers that have occurred in recent years is that it makes it easier to transfer patients, the Star Tribune of Minnesota reports. That’s given rise to a term that’s fairly new but might become more prominent in health care reportage: diagnostic discordance. 

Actually, the Star Tribune was reporting on a study by researchers at the University of Minnesota and appearing in the Journal of General Internal Medicine. Diagnostic discordance happens when a patient leaves one hospital with a certain set of diagnoses and is admitted to another and given different diagnoses. Examples include when a patient with a heart attack is transferred from one hospital’s emergency department to another’s cardiac unit, or when a patient with mental health problems goes from one facility to another in which a bed has opened on a mental health ward. “Mergers have fueled the increase, as small hospitals consolidate services and send complex patients to larger affiliated hospitals,” the newspaper reports.

The researchers looked at 180,000 transfers among hospitals in five states and found discrepancies in 85% of the transfers. “Exactly how inconsistent records aggravate the problem for transferred patients is unclear,” the Star Tribune reports. “Patients who get transferred tend to be sicker and have more complicated medical records, which increases the chances for discrepancies. Their frail conditions also increase their risk of dying in care. So it’s possible that diagnostic discord isn’t a cause of in-hospital deaths, but rather a red flag of the risk.”