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The Ulster Medical Journal logoLink to The Ulster Medical Journal
. 1999 Nov;68(2):73–78.

A comparison of open access endoscopy and hospital-referred endoscopy in a district general hospital.

S D Johnston 1, J Kirby 1, E Mackle 1, T J Robinson 1
PMCID: PMC2449108  PMID: 10661632

Abstract

Open access endoscopy (OAE) is widely used in many hospitals. The aim of this study was to compare the upper gastrointestinal endoscopies referred to as "OGDs" performed under the OAE service and those referred from hospital outpatient clinics (HR) during the initial year in which an OAE service was provided in a district general hospital. A retrospective review of medical records from all patients undergoing OGD during the first year of OAE to identify the waiting time for OGD, the extent of pre-treatment at the time of OGD, the endoscopic findings and the number of endoscopies in which oesophageal or gastric neoplasia was detected. Follow-up endoscopies (n = 41) were excluded. Of 739 OGDs included, 384 (177 male; mean age 48.0 yrs.) were performed under the OAE service, 346 (149 male; mean age 50.7 yrs.) were referred from outpatient clinics and 9 could not be accurately classified. The waiting time was significantly lower in the OAE group compared to the HR group (24.5 v. 29.8 days, p<0.001). Pre-treatment at the time of OGD was significantly more frequent in the OAE group compared to the HR group (295 v. 186, p<0.001). Frequencies of the main endoscopic diagnoses did not differ significantly between the two groups. The OAE service provided faster access to OGD than the HR group and the endoscopic findings were similar in the two groups.

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Selected References

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  1. Adang R. P., Vismans F. J., Ambergen A. W., Talmon J. L., Hasman A., Flendrig J. A. Evaluation of computerised questionnaires designed for patients referred for gastrointestinal endoscopy. Int J Biomed Comput. 1991 Oct;29(1):31–44. doi: 10.1016/0020-7101(91)90011-3. [DOI] [PubMed] [Google Scholar]
  2. Bytzer P., Hansen J. M., Havelund T., Malchow-Møller A., Schaffalitzky de Muckadell O. B. Predicting endoscopic diagnosis in the dyspeptic patient: the value of clinical judgement. Eur J Gastroenterol Hepatol. 1996 Apr;8(4):359–363. doi: 10.1097/00042737-199604000-00014. [DOI] [PubMed] [Google Scholar]
  3. Dickey W., Kenny B. D., McConnell J. B. Effect of proton pump inhibitors on the detection of Helicobacter pylori in gastric biopsies. Aliment Pharmacol Ther. 1996 Jun;10(3):289–293. doi: 10.1111/j.0953-0673.1996.00289.x. [DOI] [PubMed] [Google Scholar]
  4. Froehlich F., Burnand B., Pache I., Vader J. P., Fried M., Schneider C., Kosecoff J., Kolodny M., DuBois R. W., Brook R. H. Overuse of upper gastrointestinal endoscopy in a country with open-access endoscopy: a prospective study in primary care. Gastrointest Endosc. 1997 Jan;45(1):13–19. [PubMed] [Google Scholar]
  5. Gonvers J. J., Burnand B., Froehlich F., Pache I., Thorens J., Fried M., Kosecoff J., Vader J. P., Brook R. H. Appropriateness and diagnostic yield of upper gastrointestinal endoscopy in an open-access endoscopy unit. Endoscopy. 1996 Oct;28(8):661–666. doi: 10.1055/s-2007-1005573. [DOI] [PubMed] [Google Scholar]
  6. Griffin S. M., Raimes S. A. Proton pump inhibitors may mask early gastric cancer. Dyspeptic patients over 45 should undergo endoscopy before these drugs are started. BMJ. 1998 Dec 12;317(7173):1606–1607. doi: 10.1136/bmj.317.7173.1606. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Heaney A., Collins J. S., Tham T. C., Watson P. R., McFarland J. R., Bamford K. B. A prospective study of the management of the young Helicobacter pylori negative dyspeptic patient--can gastroscopies be saved in clinical practice? Eur J Gastroenterol Hepatol. 1998 Nov;10(11):953–956. doi: 10.1097/00042737-199811000-00009. [DOI] [PubMed] [Google Scholar]
  8. Holdstock G., Bruce S. Endoscopy and gastric cancer. Gut. 1981 Aug;22(8):673–676. doi: 10.1136/gut.22.8.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Johannessen T., Petersen H., Kleveland P. M., Dybdahl J. H., Sandvik A. K., Brenna E., Waldum H. The predictive value of history in dyspepsia. Scand J Gastroenterol. 1990 Jul;25(7):689–697. doi: 10.3109/00365529008997594. [DOI] [PubMed] [Google Scholar]
  10. Mahajan R. J., Agrawal S., Barthel J. S., Marshall J. B. Are patients who undergo open-access endoscopy more anxious about their procedures than patients referred from the GI clinic? Am J Gastroenterol. 1996 Dec;91(12):2505–2508. [PubMed] [Google Scholar]
  11. Mahajan R. J., Barthel J. S., Marshall J. B. Appropriateness of referrals for open-access endoscopy. How do physicians in different medical specialties do? Arch Intern Med. 1996 Oct 14;156(18):2065–2069. [PubMed] [Google Scholar]
  12. Saunders B. P., Trewby P. N. Open access endoscopy: is the lost outpatient clinic of value? Postgrad Med J. 1993 Oct;69(816):787–790. doi: 10.1136/pgmj.69.816.787. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Silcock J. G., Bramble M. G. Open access gastroscopy: second survey of current practice in the United Kingdom. Gut. 1997 Feb;40(2):192–195. doi: 10.1136/gut.40.2.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Silverstein M. D., Petterson T., Talley N. J. Initial endoscopy or empirical therapy with or without testing for Helicobacter pylori for dyspepsia: a decision analysis. Gastroenterology. 1996 Jan;110(1):72–83. doi: 10.1053/gast.1996.v110.pm8536890. [DOI] [PubMed] [Google Scholar]
  15. Zuccaro G., Jr, Provencher K. Does an open access system properly utilize endoscopic resources? Gastrointest Endosc. 1997 Jul;46(1):15–20. doi: 10.1016/s0016-5107(97)70203-7. [DOI] [PubMed] [Google Scholar]

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