McClellan David A, Ojinnaka Chinedum O, Pope Robert, Simmons John, Fuller Katie, Richardson Andrew, Helduser Janet W, Nash Phillip, Ory Marcia G, Bolin Jane N
From the Department of Clinical & Translational Medicine, College of Medicine, Texas A&M University, Bryan (DAM, RP, JS, KF, AR); Texas A&M Physicians Family Medicine Residency, Texas A&M University, Bryan (DAM, RP, JS, KF, AR, PN); the Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station (COO, JWH, JNB); and the Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station (MGO).
J Am Board Fam Med. 2015 Nov-Dec;28(6):713-21. doi: 10.3122/jabfm.2015.06.140342.
An inadequate supply of physicians who perform colonoscopies contributes to suboptimal screening rates, especially among the underserved. This shortage could be reduced if primary care physicians perform colonoscopies. This purpose of this article is to report quality indicators from colonoscopy procedures performed by family medicine physicians as part of a colorectal cancer prevention program targeting uninsured, low-income individuals.
A grant-funded colorectal cancer screening program was implemented to increase access to affordable colonoscopies for underinsured or uninsured residents of target counties while providing colonoscopy training to family medicine resident physicians. Colonoscopies were performed or supervised by 4 board-certified family physicians. Data were collected between 2011 and 2014.
A total of 1155 colonoscopies were performed on 1101 individuals over a 3-year period. Cecal intubation rate was 96.25%. Adenoma detection rates among men and women >50 years old were 38.15% and 25.96%, respectively. There was 1 perforation, which was referred to a hospital, and 1 instance of postprocedural bleeding, which spontaneously resolved.
Primary care physicians performing colonoscopies met the recommended quality indicators set forth by the American Society for Gastrointestinal Endoscopy.
进行结肠镜检查的医生供应不足导致筛查率不理想，尤其是在医疗服务不足的人群中。如果初级保健医生进行结肠镜检查，这种短缺情况可能会得到缓解。本文的目的是报告家庭医学医生进行的结肠镜检查程序的质量指标，这些检查是针对未参保的低收入人群的结直肠癌预防计划的一部分。
实施了一项由赠款资助的结直肠癌筛查计划，以增加目标县未参保或未充分参保居民获得负担得起的结肠镜检查的机会，同时为家庭医学住院医生提供结肠镜检查培训。结肠镜检查由4名获得委员会认证的家庭医生进行或监督。在2011年至2014年期间收集数据。
在3年时间里，对1101人共进行了1155次结肠镜检查。盲肠插管率为96.25%。50岁以上男性和女性的腺瘤检出率分别为38.15%和25.96%。发生1例穿孔，转诊至医院，还有1例术后出血，自行缓解。
进行结肠镜检查的初级保健医生达到了美国胃肠内镜学会制定的推荐质量指标。
