Open access gastroscopy in hospitalized patients

Area of Science:

• Gastroenterology
• Endoscopy
• Health Services Research

Background:

• Open access gastroscopy (OAG) enables direct physician referrals for endoscopic procedures, bypassing pre-procedure consultations.
• This model aims to streamline patient care and resource utilization within gastroenterology services.

Purpose of the Study:

• To compare the safety and efficacy of OAG versus traditional gastroscopy requiring a prior gastroenterological consultation.
• To evaluate indications, patient characteristics, diagnostic yield, and outcomes between the two referral methods.

Main Methods:

• A prospective study compared 236 patients referred for OAG with 258 patients referred after consultation.
• Data collected included indications, background diseases, outcomes, and diagnostic yield.
• Referring physicians received education on OAG indications; questionnaires were used for data collection and analysis.

Main Results:

• Hospitalization in internal medicine was the sole independent factor for OAG referral.
• Severe comorbidities and aspirin use did not influence OAG use but acted as caution flags for consultants.
• No significant differences were observed in diagnostic yield (26.4% OAG vs. 28.3% consultation) or mortality rates.

Conclusions:

• Open access gastroscopy is a feasible and beneficial model in academic medical centers.
• OAG demonstrates no bias in indication appropriateness or reduction in diagnostic yield compared to traditional referrals.
• Referring physicians require enhanced awareness regarding safety considerations for OAG procedures.