Primary panendoscopy.
Primary panendoscopy is defined as a limited-consultative, diagnostic, UGI endoscopic examination that provides, in non-critically ill patients with dyspeptic symptoms, an accurate and cost-effective alternative to the standard UGI x-ray examination. The procedure was instituted at St. Mary's Medical Center's hospital in February 1985. During the first 12 months, a total of 321 patients were examined: 212 inpatients and 109 outpatients. In those patients with complete information, primary panendoscopy changed the diagnosis in 67% and the treatment in 52%. As expected, the number of esophagogastroduodenoscopies decreased during this time, but the combined numbers of primary panendoscopies and esophagogastroduodenoscopies exceeded the projected increase of esophagogastroduodenoscopies. Similarly, the number of UGI x-ray examinations fell sharply. With a physician fee of $150.00 and a facility fee of $50.00, theoretical savings of some $117,000.00 to the patients were estimated. The authors conclude that primary panendoscopy provides a cost-effective and beneficial patient service that warrants broad consideration by gastroenterologists as they face the cost constraints being imposed within the health care system of the 1980s.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D002648:Child; D003365:Costs and Cost Analysis; D004378:Duodenal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D004384:Duodenoscopy / Q000191:economics / Q000706:statistics & numerical data; D004415:Dyspepsia / Q000175:diagnosis; D004935:Esophageal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D004945:Esophagoscopy / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005773:Gastroscopy / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013272:Stomach Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D013997:Time Factors