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

Anna-Lena Walter, Florent Baty, Frank Rassouli, Stefan Bilz, Martin Hugo Brutsche
2021 Orphanet Journal of Rare Diseases  
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
more » ... ital 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.
doi:10.1186/s13023-021-01769-6 pmid:33745447 fatcat:7qsrot65gvbqpbi3u74mwogdh4