@article{13348,
  author = {Courtney A Sump and Trisha L Marshall and Anna J Ipsaro and Shivani J Patel and Dane C Warner and Patrick W. Brady and Philip A. Hagedorn},
  title = {Uncertain diagnoses in a children’s hospital: patient characteristics and outcomes},
  abstract = {<jats:title>Abstract</jats:title>
<jats:sec id="j_dx-2019-0058_s_999">
<jats:title id="d155949e341">Background</jats:title>
<jats:p>A quality improvement initiative at our institution resulted in a new process for prospectively identifying pediatric hospital medicine (PHM) patients with uncertain diagnoses (UD). This study describes the clinical characteristics and healthcare utilization patterns of patients with UD.</jats:p></jats:sec>
<jats:sec id="j_dx-2019-0058_s_998">
<jats:title id="d155949e349">Methods</jats:title>
<jats:p>This single center cross-sectional study included all PHM patients identified with UD during their admission. A structured chart review was used to abstract patient demographics, primary symptoms, discharge diagnoses, and healthcare utilization patterns, including consult service use, length of stay (LOS), escalation in care, and 30-day healthcare reutilization. Appropriate descriptive statistics were used for categorical and continuous variables.</jats:p></jats:sec>
<jats:sec id="j_dx-2019-0058_s_997">
<jats:title id="d155949e357">Results</jats:title>
<jats:p>This study includes 200 PHM patients identified with UD. Gastrointestinal symptoms were the primary finding in 45% of patients with UD. Consult service use was highly variable, with a range of 0–8 consult services for individual patients. The median LOS was 1.6 days and only 5% required a rapid response team evaluation. As for reutilization, 7% of patients were readmitted within 30 days.</jats:p></jats:sec>
<jats:sec id="j_dx-2019-0058_s_996">
<jats:title id="d155949e365">Conclusions</jats:title>
<jats:p>This descriptive study highlights the heterogeneity of patients with uncertain diagnoses. Ongoing work is needed to further understand the impact of UD and to optimize the care of these patients.</jats:p></jats:sec>},
  year = {2021},
  journal = {Diagnosis},
  volume = {8},
  pages = {353-357},
  month = {01/2020},
  issn = {2194-802X},
  doi = {10.1515/dx-2019-0058},
}