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Open access endoscopy for hospitalized patients

A D Sperber¹, A Fich, L Eidelman

¹Department of Gastroenterology, Soroka Medical Center, Beer-Sheva, Israel.

The American Journal of Gastroenterology

|October 23, 1997

Summary

Implementing open access endoscopy for hospitalized patients significantly reduced consultation requests without increasing procedure volume. Most direct referrals for endoscopy had appropriate indications, improving efficiency.

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Area of Science:

Gastroenterology
Medical Policy
Health Services Research

Background:

Gastroenterology consultations for hospitalized patients often involve endoscopic procedures.
Open access endoscopy has shown promise for outpatient settings.
Evaluating open access for inpatients is crucial for optimizing care.

Purpose of the Study:

To assess the impact of an open access endoscopy policy for hospitalized patients.
To determine if direct referral for endoscopy affects consultation numbers and procedure volume.
To gauge physician satisfaction with the open access system.

Main Methods:

Implemented an open access policy for upper endoscopy (esophagogastroduodenoscopy, EGD) and flexible sigmoidoscopy (FS) for inpatients.
Compared monthly consultation requests and procedure numbers pre- and post-policy implementation.

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Conducted a physician satisfaction survey regarding the new system.

Main Results:

Monthly consultations decreased significantly (30.7 vs. 119.3, p=0.006).
Total endoscopies showed no significant increase (286 vs. 253).
Physicians reported high satisfaction and favored continuation of the open access policy.

Conclusions:

Open access endoscopy for hospitalized patients effectively reduces consultation requests.
The policy ensures appropriate indications for direct endoscopic referrals.
This approach optimizes gastroenterology resource utilization for inpatients.