Article 1986

Paramedicals' Clinical Accuracy: In 102 Cases Referred to a Provincial Hospital

Tropical Doctor
Journal · Vol. 16 · Issue 1 · pp. 38-43
Abstract

A random sample of 102 cases referred in 1983 by paramedicals to the Southern Highlands Provincial Hospital, Papua New Guinea, was analysed for agreement with the final hospital diagnosis and with standardized primary care therapies. Health centre diagnosis was judged accurate in 45% of cases; inaccuracies in a further 17% had no projected health consequences. However, resulting serious sequelae could be projected in half of the incorrect diagnoses. Diagnosis of surgical cases was more often accurate (P<0.05) than in medical cases. Treatment which was adequate or standard for the diagnosis made at the health centre had been given there in 80% of cases. However, there were serious diagnostic inaccuracies in 38% of all referral cases; this study suggests a need for problem-based paramedical education in diagnosis, especially in non-surgical problems. Visits by doctors to health centres could reinforce this diagnostic teaching and better evaluate paramedicals' clinical accuracy in the health centre. © 1986, SAGE Publications. All rights reserved.

Keywords

Author Keywords

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Index Keywords

adult clinical competence female human male adolescent Vocational education curriculum education diagnosis Evaluation Health Personnel comparative study Physicians major clinical study program evaluation organization and management Hospitals personnel management Developing countries child Educational activities pregnancy health care paramedical profession paramedical personnel Allied Health Personnel Medicine Infant, Newborn infant Child, Preschool Sex Factors health services Delivery of Health Care health primary health care geographic distribution Quality of Health Care Research Report Comparative studies Organization and Administration Management Programs Middle Age Recommendations Examinations And Diagnoses Health Facilities Health Services Evaluation Manual Medical Supervision Melanesia Oceania Papua New Guinea Physical Examinations And Diagnoses Qualitative Evaluation Research Methodology Studies Supervision Therapeutics
Author Affiliations
Department of Family & Community Medicine, University of Arizona College of Medicine – Tucson, Tucson, AZ, United States
Funding & Acknowledgements
No funding information
References 10 References
1 Standard Treatment of Common Illnesses of Children of Papua New Guinea, (1982)
2 Diagnostic Pathways in Clinical Medicine, (1977)
3 Essex, B. J., The use of flow charts in training, World Health Forum, 3, 4, pp. 380-384, (1982)
4 Obstetrics and Gynaecology for Nurses, (1978)
5 Lennox, Christopher E., Standard treatments - a must but a myth, Papua and New Guinea Medical Journal, 22, 2, pp. 140-144, (1979)
6 Lennox, Christopher E., Surgical Experience of Tribal Warfare in Papua New Guinea, Tropical Doctor, 9, 4, pp. 184-188, (1979)
7 Competency Based Curriculum Development in Medical Education, (1978)
8 National Health Plan 19741978, (1974)
9 Pust, Ronald E., Analysing referral patterns to rural provincial hospitals, Tropical Doctor, 15, 2, pp. 95-97, (1985)
10 Papua New Guinea Medical Journal, (1975)
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