Patient understanding of discharge diagnoses: Prevalence and predictors

BackgroundPatients have a right to be given the information that will enable them understand their diagnosis. However, as 40% of patients have recalled their discharge diagnosis in previous studies, and understanding was sub-optimal. Our aim was to establish (1) patients’ understanding of diagnosis and (2) factors which may influence this.MethodsAll medical patients discharged from a large urban hospital over a 30-day period were contacted within 7 days. Primary outcome was patients’ understanding of primary diagnosis. Patient perception of understanding and agreement that diagnosis had been explained were also assessed.ResultsSeventy-four percent (336) of 452 patients were successfully surveyed. Mean age was 62.9 years (SDP 18.1); 10.7% (36) had AMTS less than 8. Seventy-two percent (243) had good understanding of their diagnosis, and could identify and/or explain the pathology. Three quarters (258) patients felt they understood their diagnosis; 81.3%; (273) asserted their diagnosis was explained during their stay. On multivariate analysis, increasing age, poorer cognition (both p < 0.001), lack of recall of presenting complaint, and cardiac diagnosis (both p 0.02) were independent predictors of poor understanding. Older age and AMTS less than 8 independently predicted self-reported understanding of diagnosis, and patient-perceived lack of explanation (both p < 0.001).ConclusionsWhile most patients understood their diagnoses well, even small misunderstandings may affect health behaviours. High-risk patients, including older patients or those with cognitive impairment, should be identified and offered additional assistance at discharge.