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[减少上部胃肠内镜的请求:上部胃肠内镜不是消化不良的解决方案]
Victorine H Roos1,2, Daniel Keszthelyi1
1Maastricht Universitair Medisch Centrum+, afd. Maag-, Darm- en Leverziekten, Maastricht.
Nederlands tijdschrift voor geneeskunde
|July 26, 2023
概括
许多消化不良的上部肠道内镜缺乏诊断价值,特别是在年轻的患者中. 解决方案包括患者教育和改善医疗保健专业人士的指导,以减少不必要的程序.
科学领域:
- 胃肠病学 胃肠病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 上部胃肠道 (GI) 内镜经常用于消化不良.
- 诊断产量通常是有限的,特别是在60岁以下没有警报症状的患者中.
- 内镜容量是一个重要的限制.
研究的目的:
- 为了解决不必要的上部肠道内镜的问题.
- 为优化内镜利用提出解决方案.
- 为了降低与非指示程序相关的医疗保健成本.
主要方法:
- 审查当前的荷兰指南上部肠道内镜指示.
- 对开放式内镜实践的分析.
- 识别潜在的干预措施,以减少非适用的内镜.
主要成果:
- 在荷兰,大约40%的开放式上部肠道内镜检查不符合指导方针.
- 这导致了相当大的成本,诊断收益有限.
- 有几种策略可以减少不必要的程序.
结论:
- 减少不必要的上部肠道内镜对于成本效益和资源管理至关重要.
- 潜在的解决方案包括数字患者教育,专家咨询和专业教育.
- 政策变化,例如调整财政补偿,也可能起到作用.
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