International comparison study on elucidation of causes of physician's diagnostic error

2023 Fiscal Year Final Research Report

• Project/Area Number: 20H03913
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Review Section: Basic Section 58010:Medical management and medical sociology-related
• Research Institution: Shimane University
• Principal Investigator: WATARI TAKASHI 島根大学, 学術研究院医学・看護学系, 准教授 (00792037)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 診断エラー / 患者安全 / 患者中心性 / 医療訴訟 / 誤診

Outline of Final Research Achievements

In the United States, diagnostic errors are estimated to result in approximately 80,000 deaths annually and account for about 20% of total healthcare costs. Our team conducted an analysis of physicians' reflections on diagnostic errors (n=687) and a study of medical malpractice claims (n=3430) to elucidate the actual state and contributing factors of diagnostic errors from various perspectives. In our analysis of diagnostic error cases among internal medicine physicians in Japan, we found that general outpatient clinics (35%) and emergency departments (31%) had particularly high incidences. Diagnostic errors were significantly more likely to occur in settings with high diagnostic uncertainty, such as during night shifts, holidays, or in environments with limited medical resources. This finding was further substantiated through collaborative research with the University of Michigan and Harvard University.

Free Research Field

医療の質・安全

Academic Significance and Societal Importance of the Research Achievements

日本における診断エラーの研究は重要な意義を持つ。学術的には、診断エラーの発生状況や要因を多角的に明らかにすることで、医療現場での診断プロセスの改善に貢献する。特に、一般外来と救急外来での診断エラーの高発生率と、それに影響を与える要因を特定することで、診断の質向上に向けた具体的な対策を提案することができた。また、限られた医療資源下での診断エラーリスクを明示することは、労働環境の改善や医療政策の見直しに寄与するであろう。社会的には、診断エラーの防止は患者の安全を守り、医療費の削減にもつながる。これらの研究成果は、日本の医療制度全体の質向上に寄与し、国民の健康増進に大きく貢献するものである。