Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study

AIMS: 1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. SETTINGS AND DESIGN: Comparative, cross-sectional and non-interventional study. METHODS AND MATERIAL: It is retrospective, record-based study conducted upon inpatients (n = 200) of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. STATISTICAL ANALYSIS USED: Comparative analysis of specific and selective gaps were estimated in terms of percentage (%). RESULTS: Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. CONCLUSIONS: The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.