Diagnostic Errors in Low and Middle-Income Countries: Future Health and Economic Burden for Patient Safety

Editorial

Austin Emerg Med. 2016;

Diagnostic Errors in Low and Middle-Income Countries: Future Health and Economic Burden for Patient Safety

Mahumud RA1*,2, Sultana M1, Sheikh N1, Ali MN1, Mitra DK2 and Sarker AR1

¹Health Economics and Financing Research, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh

²School of Public Health, Independent University, Bangladesh

*Corresponding author: Rashidul Alam Mahumud, Health Economics and Financing Research, Health System and Population Studies Division, icddr,b, 68, Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh

Received: November 03, 2016; Accepted: November 11, 2016; Published: November 14, 2016

Editorial

Diagnostic error is one of the leading causes of medical malpractice resulting an under recognized patient safety concern [1,2]. Moreover, the health burden has been expanded heavily due to diagnostic error in the past few decades. Globally, an estimated 94,000 -142,000 people died from 1990 to 2013 from adverse effects of diagnostic errors [3]. In developed countries experience ~850,000 diagnostic errors each year; that leads to huge health and economic burden [1]. It is also a rising burden of diagnostic error faced by low- and middle-income countries (LMICs) [4,5]. Whereas compounded through experiences of limited health care infrastructure, disappointingly trained health workforce as well as inappropriate health facilities has significantly contributed to the low quality of health services in LMICs [4]. However, affordability to acquire medicines and access to adequate health care remains a barrier for the people with LMICs while diagnostic error that leads to wrong treatment creates an additional health and economic burden. Regarding the disease patterns, it has been shifted remarkably from communicable to Non-communicable disease accompanied with socioeconomic progress in LMICs [6] due to epidemiological transition attributed by the emerging magnitude of chronic and degenerative diseases. The burden of NCDs accounted for 86% and 37% for high-income and low-income countries respectively in 2008, while it has been assumed to be raised unto one-half of the disease burdens by 2030 indicating NCDs as growing concerns for LMICs [4,6,7]. However, children and elderly are suffered more due to infectious and parasitic diseases and caused a major share of disease burden for LMICs. On the other hand, non-communicable disease (NCD), comprising cardiovascular disease, diabetes, stroke, and chronic pulmonary diseases, has been contributing to increasing patient health burden due to diagnostic error rapidly in LMICs [4,7].

The World Health Organization (WHO) recently prioritized patient safety areas strengthening in primary health care addressing the consequences of diagnostic error, especially for LMICs [8].

A diagnostic error is any mistake or failure in the diagnostic procedure leading to a misdiagnosis, a delayed diagnosis, or a missed diagnosis [9]. It can be considered ‘missed’ (no diagnosis like as patient missed at different care appointments alarming symptoms), ‘wrong’ (incorrect diagnosis was completed prior to the true diagnosis) or ‘delayed’ (the necessary information to make the diagnosis was available earlier) [9,10]. However, it is difficult to determine the three; missed and wrong scenarios, and delayed diagnosis. The evolution of diagnoses over time generally formulates it challenging to isolate a diagnostic error considering the definitions and dimensions. In addition, the diagnostic course can also expand across various providers and in different surroundings [10]. On the other hand, there are no standard guidelines for ‘timely’ diagnosis for the mainstream of patient health conditions [11].

Diagnostic errors occur from the three different contributing causes such as cognitive errors related to faulty data gathering (Figure 1), faulty information processing and faulty metacognition; systems causes linked to availability and functioning of medical equipment and connection between different practitioners into the health care system [9,12].

Citation: Mahumud RA, Sultana M, Sheikh N, Ali MN, Mitra DK and Sarker AR. Diagnostic Errors in Low and Middle-Income Countries: Future Health and Economic Burden for Patient Safety. Austin Emerg Med. 2016; ISSN : 2473-0653