Many patients are discharged without a diagnosis

Chest pain, breathing difficulties, fainting. Each year approx. 265,000 Danes are acutely admitted to medical departments with symptoms of serious illness. New research from Aarhus University and Aarhus University Hospital now shows that many of them – as many as every fourth patient – are sent home again without receiving a diagnosis of the severe symptoms that led to the acute hospitalisation.

"Naturally, there is no need for a diagnosis if the examinations at the hospital disprove that there is a serious illness. So some patients will always be discharged without a specific diagnosis. But we are surprised that as many as one in four patients do not receive a specific diagnosis," says Clinical Associate Professor and Medical Doctor Christian Fynbo Christiansen. He is behind the study together with colleagues from Aarhus University and Aarhus University Hospital.

The researchers have not used the study to analyse why so many patients are not given a specific diagnosis during acute hospitalisation. Christian Fynbo Christiansen does, however, point to a possible explanation:

"When the figure is as high as it is, we should consider whether these patients are adequately examined during the hospitalisation. Because if this is not the case there can be a risk of both deterioration and re-hospitalisation."

The patients who did not receive a diagnosis before being sent home were on average admitted for a single day.

First mapping out of acute patients

The study is the first in the world to map out diagnoses and chronic disease on a national level for all medical patients that are acutely admitted to hospital during the course of a year. In the study the researchers from Aarhus University analysed data from 264,265 Danish patients who were acutely admitted to medical departments in 2010.

The study also shows that almost half of the patients suffer from chronic diseases. As the number of elderly people increases, the number of patients with one or more chronic disease will also increase. Christian Fynbo Christiansen therefore believes that the results of the study can be used in the future planning of the healthcare sector:

"With the knowledge we have now, we should be especially careful planning the healthcare system, including the emergency departments at the upcoming so-called super hospitals, so they can handle a large number of patients who cannot be immediately diagnosed. It is clearly extremely important for both the individual patient and the healthcare system as a whole that patients with serious and critical diseases are diagnosed as well as possible when they are first admitted."

The study has just been published in the prestigious scientific journal European Journal of Internal Medicine.

Facts

• 264,265 acute medical patients, who had been acutely admitted in 2010, were identified through the Danish National Patient Registry.
• The average age of the patients was 64.
• In eleven out of fifteen patient groups the majority of the patients were in aged 60-79.
• On average the patients were admitted to hospital for two days.

For more information

The original article "Acute admissions to medical departments in Denmark: Diagnoses and patient characteristics" can be downloaded here: http://www.ncbi.nlm.nih.gov/pubmed/24997487 

Contact

Staff Specialist, Clinical Associate Professor, PhD, Christian Fynbo Christiansen
Aarhus University, Department of Clinical Medicine, Department of Clinical Epidemiology
Email: cc@dce.au.dk
Tel: +45 8716 8218 / +45 2020 8398

Professor, Consultant, MD, PhD Henrik Toft Sørensen
Aarhus University, Department of Clinical Medicine, Department of Clinical Epidemiology
Email: hts@dce.au.dk
Tel: +45 8716 8215 / +45 5168 0555