Overuse of upper gastrointestinal endoscopy in a country with open-access endoscopy: a prospective study in primary care.
Détails
ID Serval
serval:BIB_873
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Overuse of upper gastrointestinal endoscopy in a country with open-access endoscopy: a prospective study in primary care.
Périodique
Gastrointestinal endoscopy
ISSN
0016-5107
ISSN-L
0016-5107
Statut éditorial
Publié
Date de publication
1997
Peer-reviewed
Oui
Volume
45
Numéro
1
Pages
13-9
Langue
anglais
Résumé
BACKGROUND: This prospective observational study was aimed at evaluating the appropriateness of use of upper gastrointestinal endoscopy (UGE) in primary care in a country with open access to and high availability of the procedure. METHODS: Outpatients were consecutively included in two clinical settings: Setting A (20 primary care physicians during 4 weeks) and B (university-based outpatient clinic during 3 weeks). In patients undergoing UGE, appropriateness of referral was judged by explicit Swiss criteria developed by the RAND/UCLA panel method. RESULTS: Patient visits (8135) were assessed. Six hundred eleven patients complained of upper gastrointestinal symptoms. Physicians decided to perform UGE in 63 of these patients. Twenty-five (40%) of the endoscopies were rated appropriate, 7 (11%) equivocal, and 31 (49%) inappropriate. Overuse of UGE occurred in 5.1% (setting A: 4.7%; setting B:6.5%; p = 0.39) of the patients who presented with upper gastrointestinal symptoms. The decision to perform UGE in previously untreated dyspeptic patients was the most common clinical situation resulting in overuse. CONCLUSIONS: Inappropriate use of UGE is high in Switzerland. However, to better reflect primary care decision making, overuse should be related not only to patients referred for a medical test, but also to the number of patients who complain of the symptoms that would be investigated by the procedure.
Mots-clé
Adolescent, Adult, Aged, Endoscopy, Gastrointestinal, Evaluation Studies as Topic, Female, Gastrointestinal Diseases, Health Services Misuse, Humans, Male, Middle Aged, Primary Health Care, Prospective Studies, Switzerland, Unnecessary Procedures
OAI-PMH
Pubmed
Web of science
Création de la notice
19/11/2007 13:47
Dernière modification de la notice
20/08/2019 15:46