Physician-expert Insights on the Variable Costs of Delayed Diagnoses Across 6 Conditions

Delayed diagnoses are common and costly in the United States. The costs of diagnostic delay likely vary across diseases, yet the dimensions explaining this variability remain poorly characterized. This study aims to describe clinician perspectives on the types of costs and challenges associated with estimating the costs of delayed diagnosis.

Thirteen clinicians with expertise in diagnostic excellence across 6 conditions-myocardial infarction, lung cancer, ankylosing spondylitis, preeclampsia, pediatric appendicitis, and sepsis-were interviewed using a semistructured format. Participants were selected for their clinical and research experience, representing diverse diagnostic pathways and clinical settings. Interviews explored perceptions of costs associated with diagnostic delay, causes of delay, and disease-specific challenges to cost estimation, using an inductive qualitative approach to extract and synthesize insights.

Interviewees characterized costs across 4 broad categories, including both financial and nonfinancial: health costs, healthcare costs, nonhealthcare costs, and psychosocial costs. Furthermore, several cost multipliers, such as downstream delays and opportunity costs, were identified. Experts highlighted several condition-specific dimensions affecting cost estimation, including difficulty in identifying delay prevalence, variability in the costs associated with delay, and challenges in isolating delay-driven costs.

Understanding the variability in costs and estimation challenges is critical to advancing research and mitigating the impacts of diagnostic delay. Condition-specific factors such as diagnostic complexity, disease overlap, and treatment uncertainty must be recognized to properly contextualize cost estimates. This study offers a clinician-informed foundation for researchers seeking to address these challenges and improve methods for assessing the economic burden of delayed diagnosis.