Strategies to address increased demand for colonoscopy

Guidelines in an open endoscopy practice

Todd H. Baron, Brenda D. Kimery, Darius Sorbi, Linda C. Gorkis, Jonathan A Leighton, David E. Fleischer

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background & Aims: Since Medicare approval for reimbursement of screening colonoscopies, the number of colonoscopy requests has increased. Physician resources have often been inadequate to meet the demand. We sought to reduce the demand for colonoscopy in an open endoscopy system by using a guideline-based triage system to eliminate inappropriate procedures and to align the timing of surveillance colonoscopies with recommendations made by national organizations. Methods: This was a cohort study with primary care outpatients. From October 2002 to February 2003, 498 consecutive patients on a waiting list of 2400 awaiting colonoscopy for all indications were triaged and are the focus of the study. Selection of patients for appropriate colonoscopy was based on consensus guidelines developed for institutional use by using established published guidelines for appropriate colonoscopy indications. Results: Of the 498 consecutive patients triaged, 139 (28%) were deemed inappropriate. The most common reason was inappropriate referral for surveillance of colorectal polyps. The percentage of inappropriate referrals by the 3 largest referring specialties (internal medicine, family medicine, and gastroenterology) combined was also 28% with no statistically significant differences between specialties. Conclusions: Most referrals for colonoscopy in an open-access endoscopy system were appropriate, although about 1 in 4 were not. Use of triage and further education of physicians regarding colonoscopy may optimize colonoscopy utilization.

Original languageEnglish (US)
Pages (from-to)178-182
Number of pages5
JournalClinical Gastroenterology and Hepatology
Volume2
Issue number2
DOIs
StatePublished - Feb 2004

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Colonoscopy
Endoscopy
Guidelines
Referral and Consultation
Triage
Physicians
Waiting Lists
Gastroenterology
Internal Medicine
Medicare
Polyps
Patient Selection
Primary Health Care
Consensus
Cohort Studies
Outpatients
Medicine
Organizations
Education

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Strategies to address increased demand for colonoscopy : Guidelines in an open endoscopy practice. / Baron, Todd H.; Kimery, Brenda D.; Sorbi, Darius; Gorkis, Linda C.; Leighton, Jonathan A; Fleischer, David E.

In: Clinical Gastroenterology and Hepatology, Vol. 2, No. 2, 02.2004, p. 178-182.

Research output: Contribution to journalArticle

Baron, Todd H. ; Kimery, Brenda D. ; Sorbi, Darius ; Gorkis, Linda C. ; Leighton, Jonathan A ; Fleischer, David E. / Strategies to address increased demand for colonoscopy : Guidelines in an open endoscopy practice. In: Clinical Gastroenterology and Hepatology. 2004 ; Vol. 2, No. 2. pp. 178-182.
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