"Drop in" gastroscopy outpatient clinic--experience after 9 months.
BACKGROUND
Logistics handling referrals for gastroscopy may be more time consuming than the examination itself. For the patient, "drop in" gastroscopy may reduce uncertainty, inadequate therapy and time off work.


METHODS
After an 8-9 month run-in period we asked patients, hospital staff and GPs to fill in a questionnaire to evaluate their experience with "drop in" gastroscopy and gastroscopy by appointment, respectively. The diagnostic gain was evaluated.


RESULTS
112 patients had "drop in" gastroscopy and 101 gastroscopy by appointment. The number of "drop in" patients varied between 3 and 12 per day (mean 6.5). Mean time from first GP consultation to gastroscopy was 3.6 weeks in the "drop in" group and 14 weeks in the appointment group. The half-yearly number of outpatient gastroscopies increased from 696 before introducing "drop in" to 1022 after (47% increase) and the proportion of examinations with pathological findings increased from 42% to 58%. Patients and GPs expressed great satisfaction with "drop in". Hospital staff also acclaimed although it caused more unpredictable working days with no additional staff.


CONCLUSIONS
"Drop in" gastroscopy was introduced without increase in staff. The observed increase in gastroscopies was paralleled by a similar increase in pathological findings without any apparent disadvantages for other groups of patients. This should legitimise "drop in" outpatient gastroscopies, but it requires meticulous observation of possible unwanted effects when implemented.
Department of Gastroenterology, Medical Clinic, Telemark Hospital, 3710 Skien, Norway. Gert.Huppertz-Hauss@sthf.no
Gert
G
Huppertz-Hauss
Lubomir
L
Chengarov
Stein
S
Dahler
Anita
A
Jørgensen
Volker
V
Moritz
Jørn
J
Paulsen
Geir
G
Hoff
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001071:Appointments and Schedules; D001291:Attitude of Health Personnel; D004381:Duodenal Ulcer / Q000175:diagnosis; D004938:Esophageal Neoplasms / Q000175:diagnosis; D005240:Feasibility Studies; D005773:Gastroscopy / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000175:diagnosis; D011795:Surveys and Questionnaires; D014850:Waiting Lists; D055815:Young Adult