ASSESSMENT OF YIELD ON SAME DAY DUAL ENDOSCOPIC PROCEDURES, THEIR COST COMPARISON AND PARENTAL ACCEPTANCE IN A SINGLE INSTITUTION

Abstract

78 Little information is available on the yield of same day dual endoscopic procedures in children/adults. Methods: A chart review of 51 patients who underwent same day dual endoscopic procedures-Esophagogastroduodenoscopy and Flexible Sigmoidoscopy (EFS) or Esophagogastroduodenoscopy and Colonoscopy (EC) was done. The indications were: Chronic diarrhea (33%), Inflammatory Bowel Disease (37%), Abdominal pain (10%), Gastrointestinal bleed (16%), Failure to thrive (2%) and Graft versus Host disease (2%). Endoscopic and histologic findings were noted in each case. A cost comparison was made on both procedures being performed on the same day versus if performed on separate days. A questionnaire assessing parental satisfaction, preferences, degree of anxiety, inconvenience etc. regarding procedures being performed on the same day versus on different days was completed in 23/51 patients. Results: 41/51 (80.3%) had positive endoscopic findings. 7/10 patients with normal endoscopic exams had abnormal histologic findings. Only 3/51 (5.9%) had both negative endoscopic and histologic findings. Cost comparisons excluding professional fees were made if patients Operating room and in the Endoscopy suite. An average savings of $1292.00 for EFS/EC was noted for same day procedures in the Operating room and $615.00 for procedures done in the Endoscopy suite as compared to separate day procedures. Completed questionnaires suggested that 95% of parents preferred same day procedures. 82% of parents felt that child would be more stressed if the procedures were done on separate days. 87% of parents would have needed additional time off work and 59% would need to make special arrangements for child care. Conclusions: In carefully selected patients same day dual endoscopic procedures in children have a high positive yield, lead to significant cost savings and have a high overall acceptance by parents. Additional studies are needed to assess individual institutional trends.