title: Labor resource use for endoscopic gastric cancer screening in Japanese primary care settings: a work sampling study.
abstract: OBJECTIVE
  Endoscopic gastric cancer is screened in primary care settings, but how much resources are required to deliver this service remains unknown. This study determines how much time and human resources are used for endoscopic gastric cancer and for each component of the procedure.
  
  
  METHODS
  Upper endoscopic procedures were prospectively observed using a work sampling technique. This study analyzed data from patients who underwent upper endoscopic gastric cancer screening at primary care clinics that provide this service. The main outcome measurements were time intervals and total time intervals that considered the numbers of simultaneously engaged workers and were calculated as the product of time intervals and the number of workers, and the labor cost of individual components of each procedure.
  
  
  RESULTS
  We observed 44 upper endoscopic procedures at four outpatient clinics. Pre-procedure (preparation and pre-medication), procedure (from intubation to extubation) and post-procedure (recovery and cleaning) accounted for 34.1%, 10.6% and 54.4% of the total time, respectively. Of the overall total time intervals (mean: 4453 person-seconds), 29.3%, 14.4% and 55.7% of the total time was devoted to pre-procedure, procedure and post-procedure, respectively. The post-procedure was the most time- and labor-consuming component from the viewpoints of both total time and labor cost.
  
  
  CONCLUSIONS
  Most of the time taken to complete endoscopic gastric cancer screening is consumed by preparation, pre-medication and post-procedures in which nurses play key roles.
authors: Graduate School of Economics, Kyoto University, Kyoto, Japan ; The Hakubi Center of Advanced Research, Kyoto University, Kyoto, Japan.
authors: Rei
authors: R
authors: Goto
authors: Faculty of Social and Information Studies, Gunma University, Gunma, Japan.
authors: Kohei
authors: K
authors: Arai
authors: Faculty of Business Administration, Hosei University, Tokyo, Japan.
authors: Hirotsugu
authors: H
authors: Kitada
authors: Niigata Cancer Center Hospital, Niigata, Japan.
authors: Kazuei
authors: K
authors: Ogoshi
authors: Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
authors: Chisato
authors: C
authors: Hamashima
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer; D004724:Endoscopy / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D005762:Gastroenterology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009726:Nurses; D010045:Outpatients; D011320:Primary Health Care; D013274:Stomach Neoplasms / Q000175:diagnosis*; D013647:Task Performance and Analysis; D000078329:Workforce