Titre
Underutilization of upper gastrointestinal endoscopy.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Froehlich, F.
Auteure/Auteur
Pache, I.
Auteure/Auteur
Burnand, B.
Auteure/Auteur
Vader, J.P.
Auteure/Auteur
Fried, M.
Auteure/Auteur
Kosecoff, J.
Auteure/Auteur
Kolodny, M.
Auteure/Auteur
DuBois, R.W.
Auteure/Auteur
Brook, R.H.
Auteure/Auteur
Gonvers, J.J.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0016-5085
Statut éditorial
Publié
Date de publication
1997
Volume
112
Numéro
3
Première page
690
Dernière page/numéro d’article
7
Peer-reviewed
Oui
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.
PID Serval
serval:BIB_2651
PMID
Date de création
2007-11-19T11:23:05.800Z
Date de création dans IRIS
2025-05-20T20:39:51Z
Fichier(s)![Vignette d'image]()
En cours de chargement...
Nom
BIB_2651.P001.pdf
Version du manuscrit
preprint
Taille
284.12 KB
Format
Adobe PDF
PID Serval
serval:BIB_2651.P001
Somme de contrôle
(MD5):79a439bc6117daa92ce462aea7e026f3