The economics of diagnostic safety: Setting the scene (OECD, 17 September 2024)

Summary

The correct and timely diagnosis of a health condition is a first step in ensuring that it is properly treated or managed. However, most people will experience at least one diagnostic error in their lifetime, sometimes resulting in severe patient harm. Research shows that up to 80% of all harm caused by delayed or misdiagnosis could be preventable. Deficits in health system design and governance, clinical environments and individual provider competencies can drive poor diagnostic outcomes. This brief introduces work being done by the Organisation for Economic Co-operation and Development (OECD) to assess key drivers and barriers of diagnostic safety and estimate the economic impacts of poor diagnostic safety practices on health systems.

Content

Key findings

• Most people will experience at least one diagnostic error in their lifetime, sometimes resulting in severe patient harm and up to 80% of all harm caused by delayed or misdiagnosis could be preventable.
• Findings from the United Kingdom show that asthma overdiagnosis and underdiagnosis among children were potentially as high as 15% and 40% respectively.
• Globally, up to 70% of persons with chronic obstructive pulmonary disease (COPD) or asthma do not receive a formal diagnosis of the condition.
• A growing number of tests, tools, and systems are now available across healthcare settings to help patients and providers identify health problems, resulting in increased use of diagnostic tests and procedures. Despite new tools and technology, health systems still fail to identify health conditions due to poor clinical skills, decision making, organisation and integration of care deliver and limitations of information systems in a correct and timely way.
• In the Netherlands, repeated laboratory testing of normal test results occurred in up to 85% of hospitalised patients.
• Costs associated with false-positive mammograms and breast cancer overdiagnoses exceed USD 4 billion annually in the United States.
• Deficits in health system design and governance, clinical environments, and individual provider competencies can drive poor diagnostic outcomes, while improvements can influence better diagnostic performance.