Underutilization of upper gastrointestinal endoscopy.
Détails
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Accès restreint UNIL
Etat: Public
Version: de l'auteur⸱e
Accès restreint UNIL
Etat: Public
Version: de l'auteur⸱e
ID Serval
serval:BIB_2651
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Underutilization of upper gastrointestinal endoscopy.
Périodique
Gastroenterology
ISSN
0016-5085
ISSN-L
0016-5085
Statut éditorial
Publié
Date de publication
1997
Peer-reviewed
Oui
Volume
112
Numéro
3
Pages
690-7
Langue
anglais
Résumé
BACKGROUND & AIMS: Efforts to reduce costs in health care may raise concerns about underuse of medical procedures. This study prospectively assessed underuse of upper gastrointestinal endoscopy in a cohort of patients in whom we have recently published data on overuse of endoscopy. METHODS: Underuse was identified by formal necessity criteria for endoscopy, obtained by an explicit panel process. Outpatients were consecutively included in two clinical settings. Setting A consisted of 20 primary care physicians and 7215 patient visits that occurred within 1 month. Setting B consisted of 920 visits that occurred during 3 weeks at an outpatient clinic. RESULTS: During these 8135 visits, 611 patients complained of upper digestive symptoms; 63 of them underwent endoscopy. Underuse was identified in 72 patients (11.8%). The two clinical situations mainly responsible for underuse of endoscopy were uninvestigated peptic symptoms resistant to treatment and dysphagia. At first follow-up, 29 of the patients with initial underuse still fulfilled criteria of necessity (underuse rate, 4.7%). One-year follow-up showed underuse of endoscopy in 5 patients. CONCLUSIONS: This prospective evidence shows that underuse of a medical procedure exists. The estimated overuse and underuse of endoscopy in this cohort were approximately equal (5%). Improving quality of care will require reductions of both overuse and underuse of medical procedures.
Mots-clé
Adolescent, Adult, Aged, Endoscopy, Gastrointestinal, Female, Health Care Costs, Humans, Male, Middle Aged, Prospective Studies, Quality of Health Care
OAI-PMH
Pubmed
Web of science
Création de la notice
19/11/2007 13:23
Dernière modification de la notice
20/08/2019 14:05