Faculty of Health Sciences, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Can J Gastroenterol Hepatol. 2018 Jun 3;2018:4708270. doi: 10.1155/2018/4708270. eCollection 2018.
Canadian independent health facilities (IHFs) have been implemented to reduce hospital endoscopy volume and expedite endoscopic evaluations for patients suspected to have underlying colorectal cancer.
We conducted a retrospective review of a prospective database at a large-volume urban IHF. The primary outcomes were wait times, and the secondary outcomes were colonoscopy quality indicators and complication rates.
Median wait times from referral to colonoscopy met the recommendations set out by the Canadian Association of Gastroenterology and Cancer Care Ontario for all indications: chronic abdominal pain: 43 days; new onset change in bowel habits: 36 days; bright red rectal bleeding: 42 days; documented iron-deficiency anemia: 43 days; fecal occult blood test positive: 38 days; cancer likely based on imaging or physical exam: 23 days; chronic diarrhea and chronic constipation: 42 days; and screening colonoscopies: 55 days. Secondary outcomes of quality indicators and complication rates all met or exceeded the CCO and CAG recommendations.
This IHF met the recommended wait times for all indications for colonoscopy while maintaining high procedural quality and safety. IHFs are one solution to help meet the increasing demand for colonoscopy in Ontario.
加拿大独立健康设施（IHFs）的实施旨在减少医院内窥镜检查量，并为疑似患有潜在结直肠癌的患者加快内窥镜检查评估。
我们对一家大容量城市 IHF 的前瞻性数据库进行了回顾性研究。主要结果是等待时间，次要结果是结肠镜检查质量指标和并发症发生率。
所有适应证的转诊至结肠镜检查的中位等待时间均符合加拿大胃肠病学协会和安大略省癌症护理的建议：慢性腹痛：43 天；新出现的排便习惯改变：36 天；鲜红的直肠出血：42 天；有记录的缺铁性贫血：43 天；粪便潜血试验阳性：38 天；影像学或体检提示癌症可能：23 天；慢性腹泻和慢性便秘：42 天；以及筛查结肠镜检查：55 天。质量指标和并发症发生率的次要结果均符合或超过了 CCO 和 CAG 的建议。
这家 IHF 满足了所有适应证结肠镜检查的建议等待时间，同时保持了高程序质量和安全性。IHFs 是帮助满足安大略省结肠镜检查需求不断增加的解决方案之一。
