Document Detail


Factors associated with colonoscopy performed in nonhospital settings.
MedLine Citation:
PMID:  20652156     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Colonoscopy is being increasingly performed in facilities outside of hospitals. Regulation of these facilities is variable, and concerns regarding the quality of procedures in nonhospital (NH) settings have been raised. Further study is needed to better understand endoscopic practice in these facilities.
OBJECTIVES: To describe NH-based colonoscopy practice in Ontario from 1993 to 2005, and to identify patient (age, sex, income quintile and comorbidity) and physician (specialty and colonoscopy volume) factors associated with this practice.
METHODS: The present study was a population-based, cross-sectional analysis using health administrative data from Ontario adults who underwent at least one outpatient colonoscopy between 1993 and 2005. A total of 1,240,781 patients underwent 1,917,714 colonoscopies. The main outcome measure was the receipt of colonoscopy in an NH facility.
RESULTS: An increase in NH-based colonoscopy from 10.0% in 1993 to 15.1% in 2005 (P<0.0001) was found. In the multivariate model, younger, healthier men living in higher income areas were significantly more likely to undergo NH-based colonoscopy. Surgeons and other practitioners (eg, nongastroenterologists and noninternists) were significantly more likely to practice in NH settings. Physicians in the highest colonoscopy volume quintile were 25 times more likely to practice in NH settings than those in the lowest volume quintile (P<0.0001).
CONCLUSION: Rates of NH-based colonoscopy are rising in Ontario. High-volume endoscopists and surgeons are most likely to practice in NH settings. Given its increasing use, further study of the practice and the regulation of NH colonoscopy is warranted.
Authors:
Othman Alharbi; Linda Rabeneck; Lawrence Paszat; Duminda N Wijeysundera; Rinku Sutradhar; Lingsong Yun; Christopher M Vinden; Jill Tinmouth
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of gastroenterology = Journal canadien de gastroenterologie     Volume:  24     ISSN:  0835-7900     ISO Abbreviation:  Can. J. Gastroenterol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-23     Completed Date:  2010-09-16     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  8807867     Medline TA:  Can J Gastroenterol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  419-24     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Gastroenterology, Sunnybrook Health Services Centre, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Ambulatory Care Facilities / statistics & numerical data*
Chi-Square Distribution
Colonoscopy / statistics & numerical data*
Comorbidity
Cross-Sectional Studies
Databases, Factual
Female
Humans
Income
Linear Models
Logistic Models
Male
Medicine / statistics & numerical data
Middle Aged
Ontario
Physician's Practice Patterns / statistics & numerical data
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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