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Early discharges potentially affecting patient diagnoses

When patients seek care at a hospital in Providence County, they likely all share the assumption that they will not be sent home until the clinicians they see know what is wrong with them. However, that may not always be the case. Diagnosing a patient’s condition is typically a process rather than an event, with doctors often being asked to consider a number of factors before making a definitive diagnosis. Yet all of the information needed to make such a decision may not be available at the same that providers believe the patient is ready to be discharged. Indeed, the Agency for Healthcare Research and Quality cites “assessment and communication of problems that remain unresolved at the time of discharge” as among the most common reasons for hospital readmissions.

Among the elements needed in order to correctly diagnose a patient are:

  •          An in-person physical assessment (including a review of a patient’s bodily systems).
  •          A pathological review
  •          Laboratory tests
  •          Imaging studies
  •          A patient’s response to medication

While doctors directly oversee some of these evaluations, others require the intervention of outside parties. The results of these third party provider studies are often required for a final diagnosis. The results of such studies are often not immediately available, however. One might assume that a doctor would want patients to stay until are, yet other factors may instead influence him to send them home.

The online medical publication Verywell reports that some of the reasons behind early discharges are due to reimbursement issues. Specifically, it shows insurance payer guidelines regarding admission requirements as well as the payment for hospital-acquired infections as potentially prompting providers to get patients out of the hospital to avoid losing money. This could, however, led to delayed or missed diagnoses from providers not having sufficient information at discharge. 

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