Volume 32, Number 5—May 2026
CME ACTIVITY - Research
Frequency and Duration of Diagnostic Delays Associated with Coccidioidomycosis and Risk Factors for Missed Diagnoses, United States
Table 2
Index diagnosis visits and simulation results for missed diagnostic opportunities by setting in study of frequency and duration of diagnostic delays associated with coccidioidomycosis and risk factors for missed diagnoses, United States*
| Setting | No. potential missed opportunity visit days | Index diagnosis visits† |
Potential missed opportunities‡ |
|||
|---|---|---|---|---|---|---|
| No. index visits | % Of all index visits | No. missed opportunities (95% CI) | % Of all missed opportunities (95% CI) | |||
| Outpatient | 71,392 | 25,237 | 84.4% | 35,435 (33,277–37,741) | 73.2% (72.4%–74.1%) | |
| Emergency department | 6,985 | 1,230 | 4.1% | 3,607 (3,330–3,838) | 7.5% (7.2%–7.7%) | |
| Observational stay | 626 | 128 | 0.4% | 318 (271–365) | 0.7% (0.6%–0.7%) | |
| Inpatient | 18,897 | 3,314 | 11.1% | 9,024 (8,280–9,834) | 18.6% (17.8%–19.5%) | |
| Inpatient visit§ | 3,169 | 3,314 | 11.1% | 2,654 (2,532–2,784) | NC§ | |
*NC, not calculated. †Multiple settings may be associated with an index visit date (i.e., we are unable to order the timing of visits from claims on the same day); thus, the total number exceeds the number of individuals in the study population. ‡Multiple settings may occur on a given visit day (i.e., we are unable to order the timing of visits from claims on the same day); thus, the total number exceeds the total estimated potential missed diagnostic opportunities. §Inpatient visits represent >1 days admitted to an inpatient facility. Our analysis of missed diagnostic opportunities is based on visit days in which the patient received a symptomatically similar diagnosis on a given day. We can aggregate potential missed opportunities, index diagnoses, and estimated missed opportunities from the bootstrapping approach into the overall inpatient stay in which they occurred. However, the denominator for computing the percent of missed opportunities that occurred in each setting represents the total number of visit days representing a missed opportunity; thus, a value for aggregate inpatient visits is not computed.