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Determination by Diagnostic Outcome

Charles R. Kelley, MD; Joseph J. Mamlin, MD

JAMA. 1974;227(10):1155-1157.

Abstract
Prior to altering the pattern of medical care, a 10% sample of patients from the medical clinics of a university-related city hospital were evaluated to document aspects of the quality of medical care being given. Diagnostic outcomes were determined by data from specialized multiphasic screening that compared newly acquired medical data with physician knowledge of abnormalities recorded in the clinical record. Physicians were unaware of a variety of abnormalities in the 606 patients. These results were interpreted as unacceptable diagnostic outcomes and supported the impression that a breakdown in patient care existed. By delineating specific problem areas, this information has provided direction for the restructuring of ambulatory care.

Author Affiliations
From the Department of Medicine, Indiana University, Indianapolis. Dr. Kelley is now at Marion County General Hospital, Indianapolis.

Footnotes
Read as preliminary report before the annual meeting of the American Federation for Clinical Research, Atlantic City, May 1971.

Reprint requests to 960 Locke St, Indianapolis, IN 46202 (Dr. Kelley).

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