The document reports on a study of diagnostic concordance between patients and doctors at a large public hospital in New York City. The study found that over half of patients' reported reasons for admission did not match the reasons documented in their medical records. Discordance was higher in older patients and those with fewer years of education. Around 10% of patients could not provide any reason for their admission. The study had a small sample size and was single-site, limiting conclusions. It suggests diagnostic reconciliation discussions and record audits to improve doctor-patient concordance.

1. I don’t know why I’m in the hospital! Patient-doctor diagnostic concordance Zackary Berger, MD, PhD Assistant Professor Johns Hopkins General Internal Medicine

2. Doctors and patients think differently.

16. Discordance is greater among older patients Why am I in the hospital? Z. Berger, Hopkins GIM, ICCH Concordant (N, %) Discordant (N, %) Age >= 60 Age < 60 5 (17%) 18 (83%) 11 (48%) 12 (52%) 30 (65%) Total 16 (35%)

17. Discordant patients are less educated Why am I in the hospital? Z. Berger, Hopkins GIM, ICCH Concordant Discordant Mean years of schooling (SD) 10.6 (4.4) 8.9 (4.7)

21. Why am I in the hospital? Z. Berger, Hopkins GIM, ICCH

23. Make way for Diagnostic Reconciliation!