Potential Diagnostic Error for Emergency Conditions, Mortality, and Healthy Days at Home

PMCID: PMC12175027

PMID: 40526380

DOI: 10.1001/jamanetworkopen.2025.16400

Journal: JAMA network open

Publication Date: 2025-6-17

Authors: Lin MP, Burke RC, Sabbatini AK, Latsko E, Edlow JA, et al.

Key Points

• Potential diagnostic error rate of 3.2% across emergency hospitalizations in Medicare beneficiaries
• Potential diagnostic errors associated with increased 30-day mortality and reduced healthy days at home
• Diagnostic error rates and clinical impacts vary significantly by specific medical condition

Summary

This retrospective cohort study examined potential diagnostic errors in emergency hospitalizations among Medicare beneficiaries aged 65 and older, analyzing 302,837 emergency admissions across multiple high-risk conditions. The research investigated the frequency and clinical implications of potential diagnostic errors occurring within 9 days prior to hospitalization, revealing an adjusted potential diagnostic error rate of 3.2% with significant variation across different medical conditions.

The study found that emergency hospitalizations associated with potential diagnostic errors were linked to notably worse patient outcomes, including higher mortality rates and fewer healthy days at home within 30 days of admission. While the overall diagnostic error rate was modest, the findings highlight the critical importance of thorough initial medical assessments and the potential clinical consequences of missed or delayed diagnoses in emergency settings, particularly for older patients with complex medical profiles.