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Related Experiment Videos

Open-access endoscopy service for general practitioners.

G Holdstock, M Wiseman, C A Loehry

    British Medical Journal
    |February 17, 1979
    PubMed
    Summary
    This summary is machine-generated.

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    A new endoscopy service for general practitioner referrals did not improve patient outcomes or reduce other diagnostic tests. Despite increased endoscopy use, the detection rate for ulcers and cancers decreased, questioning the service's overall benefit.

    Area of Science:

    • Gastroenterology
    • Health Services Research

    Background:

    • A district general hospital implemented an open-access general-practitioner (GP) referral service for upper gastrointestinal endoscopy.
    • The service aimed to assess its impact over three years on patient referral patterns and diagnostic yield.

    Purpose of the Study:

    • To evaluate the effectiveness and impact of a new GP endoscopy referral service.
    • To compare patient characteristics and disease detection rates between GP-referred and hospital-referred patients.

    Main Methods:

    • Retrospective analysis of patient referral data over three years.
    • Comparison of reasons for referral, symptom duration, and disease detection rates.
    • Survey of general practitioners regarding their perception of the service's impact.

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    Main Results:

    • No significant difference in referral reasons, symptom duration, or disease detection between GP and hospital referrals.
    • Despite a rise in endoscopy use, barium-meal examinations did not decrease.
    • The detection rate for ulcers and cancers fell from 25% to 13% over the study period.

    Conclusions:

    • The increased number of endoscopies performed due to the new service was not justified by objective evidence of benefit.
    • While GPs perceived benefits in reduced clinic referrals and improved patient management, diagnostic yield did not improve.
    • Further evaluation is needed to assess the true value of negative endoscopic findings and overall service impact.