Publication

Diagnostic precision and identification of rare diseases is dependent on distance of residence relative to tertiary medical facilities

Journal Paper/Review - Mar 22, 2021

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Citation
Walter A, Baty F, Rassouli F, Bilz S, Brutsche M. Diagnostic precision and identification of rare diseases is dependent on distance of residence relative to tertiary medical facilities. Orphanet J Rare Dis 2021; 16:131.
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Type
Journal Paper/Review (English)
Journal
Orphanet J Rare Dis 2021; 16
Publication Date
Mar 22, 2021
Issn Print
Issn Electronic
1750-1172
Pages
131
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Brief description/objective

BACKGROUND
Diagnostic precision and the identification of rare diseases is a daily challenge, which needs specialized expertise. We hypothesized, that there is a correlation between the distance of residence to the next tertiary medical facility with highly specialized care and the diagnostic precision, especially for rare diseases.

RESULTS
Using a nation-wide hospitalization database, we found a negative association between diagnostic diversity and travel time to the next tertiary referral hospital when including all cases throughout the overall International Classification of Diseases version 10 German Modification (ICD-10-GM) diagnosis codes. This was paralleled with a negative association of standardized incidence rates in all groups of rare diseases defined by the Orphanet rare disease nomenclature, except for rare teratologic and rare allergic diseases.

CONCLUSION
Our findings indicate a higher risk of being mis-, under- or late diagnosed especially in rare diseases when living more distant to a tertiary medical facility. Greater distance to the next tertiary medical facility basically increases the chance for hospitalization in a non-comprehensive regional hospital with less diagnostic capacity, and, thus, impacts on adapted health care access. Therefore, solutions for overcoming the distance to specialized care as an indicator of health care access are a major goal in the future.