Patterns of use of endoscopic retrograde cholangiopancreatography in a Canadian province.
BACKGROUND
Data on current endoscopic retrograde cholangiopancreatography (ERCP) practice patterns drawn from large population-based samples are limited.


METHODS
Patterns of ERCP use were determined using billing records for ERCP, sphincterotomy, stone extraction or stent placement performed between April 1, 1994 and March 31, 2002 in Alberta from a population-based administrative database. Age-sex adjusted rates (per 1000 population) were calculated using the 1991 Canadian population as the standard.


RESULTS
The eight-year average ERCP rate was 0.98 without evidence of an increasing or decreasing trend over time. The ERCP rate was 0.85 in men and 1.12 in women. Significant regional variation in ERCP rates was seen, ranging from a low of 0.64 to a high of 1.27. The proportion of procedures that were therapeutic increased from 33% in 1994 to 70% in 2001. The likelihood of a procedure being considered therapeutic varied with the age and sex of the patient as well as the health region in which the procedure was performed.


CONCLUSIONS
The ERCP rate remained relatively stable over an eight-year time period, but the proportion of procedures that were therapeutic increased dramatically. Important regional variation in ERCP rates and therapeutic procedures exists.
Hilsden
Robert J
RJ
Department of Medicine, University of Calgary, Calgary, Alberta, Canada. rhilsden@ucalgary.ca
Romagnuolo
Joseph
J
May
Gary R
GR
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000416:Alberta / Q000453:epidemiology; D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000601:surgery; D011336:Probability; D012042:Registries; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D016717:Sphincterotomy, Endoscopic / Q000379:methods* / Q000706:statistics & numerical data*; D016896:Treatment Outcome