How we can improve the appropriateness of ambulatory gastrointestinal endoscopy: the lesson of the COVID-19 outbreak

Author:

Tursi Antonio12,Palieri Antonio Pio3,Lattarulo Vincenzo4,Elefante Antonio5,Gigliobianco Andrea6,Spinazzola Domenico7,Elisei Walter8,Papa Alfredo29

Affiliation:

1. Territorial Gastroenterology Service, ASL BAT, Andria (BT)

2. Department of Medical and Surgical Sciences, School of Medicine, Catholic University, Rome

3. Territorial Gastroenterology Service, ASL FG, Foggia

4. Territorial Digestive Endoscopy Service, Gioia del Colle Territorial Hospital, ASL BA, Gioia del Colle (BA)

5. Territorial Digestive Endoscopy Service, Mesagne Territorial Hospital, ASL BR, Mesagne (BR)

6. Sanitary District No. 13, Gioia del Colle (BA)

7. Sanitary District No. 4, Barletta (BT)

8. Division of Gastroenterology, ‘S. Camillo’ Hospital, Rome

9. Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario ‘A. Gemelli’, IRCCS, Rome, Italy

Abstract

Background The coronavirus disease 2019 (COVID-19) outbreak has significantly modified hospital and outpatient activities. Aims To assess the pandemic’s impact on the appropriateness of outpatient gastrointestinal (G.I.) endoscopy in a southern Italy Region. Methods Between 1 January 2019 and 31 December 2022, we compared the number, the type of activities, and the appropriateness of the G.I. endoscopy procedures in the four territorial gastroenterology and digestive endoscopy services of the Apulia region. Results In 2019, 11 173 outpatient procedures were provided, which dropped by about 44% (P < 0.05) during 2020. The endoscopic activity was slightly reduced during 2020 (−18.77%), while every other activity dropped significantly. During 2021–2022, the overall activities slightly increased but remained below the number of activities provided before the pandemic (P < 0.05). However, the endoscopic activity increased by +6.86% from 2019 to 2022, mainly due to more colonoscopies. During the 4 years analysed, the overall appropriateness rate of the endoscopic examinations increased during 2020 (2019: 67%; 2020: 81%) while dropping again in the following years (2021: 75%; 2022; 69%). Conclusion The appropriateness of the G.I. endoscopic procedures in the territorial gastroenterology services in the Apulia Region has improved during the acute phase of the COVID-19 pandemic, dropping again in the following years. Overall, the appropriateness of endoscopic procedures remains suboptimal; thus, educational activities are needed to improve the appropriateness rate to optimise the limited resources.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Gastroenterology,Hepatology

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