6975 Availability of colonoscopy in indiana.

Abstract

Background: Screening colonoscopy has been designated an appropriate screening strategy in average-risk persons in two major guidelines (Agency for Health care Policy and Research and American Cancer Society). Reimbursement for screening colonoscopy in average-risk persons is generally unavailable. Some have argued that colonoscopy is not sufficiently available in rural communities to provide screening colonoscopy on a wide spread basis. Method: Mail survey and telephone follow-up to endoscopy directors and/or nurse managers in all 114 Indiana hospitals. 103 of 114 have responded thus far. Results: Colonoscopy is available in 100% of hospitals. Emergency colonoscopy is available in 87% and scheduled colonoscopy 5 or 6 days per week in 88%. 30% indicated they were aware of ambulatory surgery centers in their county that perform colonoscopy and 22% know a local physician that performs office colonoscopies. Colonoscopy was performed by gastroenterologists in 84% of hospitals, by general or colorectal surgeons in 87%, and by gastroenterologists, general surgeons or colorectal surgeons in 99%. At least 1 internist or family physician performs colonoscopy at 22% and 38% of hospitals, respectively, primarily in small communities. An estimated 72,513 colonoscopies were performed in these hospitals in 1998. Conclusion: In a Midwestern state with a substantial rural population, colonoscopy equipment and colonoscopists (including colonoscopists who are presumed experts) are available in essentially all hospitals.We are currently evaluating attitudes toward and capacity of current colonoscopists and facilities to increase their volume in anticipation of screening colonoscopy. Background: Screening colonoscopy has been designated an appropriate screening strategy in average-risk persons in two major guidelines (Agency for Health care Policy and Research and American Cancer Society). Reimbursement for screening colonoscopy in average-risk persons is generally unavailable. Some have argued that colonoscopy is not sufficiently available in rural communities to provide screening colonoscopy on a wide spread basis. Method: Mail survey and telephone follow-up to endoscopy directors and/or nurse managers in all 114 Indiana hospitals. 103 of 114 have responded thus far. Results: Colonoscopy is available in 100% of hospitals. Emergency colonoscopy is available in 87% and scheduled colonoscopy 5 or 6 days per week in 88%. 30% indicated they were aware of ambulatory surgery centers in their county that perform colonoscopy and 22% know a local physician that performs office colonoscopies. Colonoscopy was performed by gastroenterologists in 84% of hospitals, by general or colorectal surgeons in 87%, and by gastroenterologists, general surgeons or colorectal surgeons in 99%. At least 1 internist or family physician performs colonoscopy at 22% and 38% of hospitals, respectively, primarily in small communities. An estimated 72,513 colonoscopies were performed in these hospitals in 1998. Conclusion: In a Midwestern state with a substantial rural population, colonoscopy equipment and colonoscopists (including colonoscopists who are presumed experts) are available in essentially all hospitals.We are currently evaluating attitudes toward and capacity of current colonoscopists and facilities to increase their volume in anticipation of screening colonoscopy.