Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S-357, San Francisco, CA, 94143, USA.
University of California San Francisco School of Medicine, San Francisco, CA, USA.
Dig Dis Sci. 2023 Mar;68(3):729-735. doi: 10.1007/s10620-022-07575-9. Epub 2022 Jun 22.
The coronavirus disease 19 (COVID-19) pandemic has disrupted healthcare delivery including elective endoscopy. We aimed to determine the prevalence of endoscopy cancellations in the COVID-19 era and identify patient characteristics associated with cancellation due to the pandemic.
Medical charts were reviewed for adults who cancelled an outpatient endoscopic procedure from 5/2020 to 8/2020. The association of patient characteristics with cancellation of endoscopy due to COVID-19 was assessed using logistic regression.
There were 652 endoscopy cancelations with 211 (32%) due to COVID-19, 384 (59%) due to non-COVID reasons, and 57 (9%) undetermined. Among COVID-19 related cancellations, 75 (36%) were COVID-19 testing logistics related, 121 (57%) were COVID-19 fear related, and 15 (7%) were other. On adjusted analysis, the odds of cancellation due to COVID-19 was significantly higher for black patients (OR 2.04, 95% CI 1.07-3.88, p = 0.03), while patients undergoing EGD (OR 0.56, 95% CI 0.31-0.99, p = 0.05) or advanced endoscopy (OR 0.18, 95% CI 0.07-0.49, p = 0.001) had lower odds of cancellation. The odds of cancelling due to COVID-19 testing logistics was significantly higher among black patients (OR 3.12, 95% CI 1.03-9.46, p = 0.05) and patients with Medi-Cal insurance (OR 2.89, 95% CI 1.21-6.89, p = 0.02).
Black race is associated with an increased risk of COVID-19 related cancellation. Specifically, black patients and those with Medi-Cal are at increased risk of cancellation related to logistics of obtaining pre-endoscopy COVID-19 testing. Racial and socioeconomic disparities in access to endoscopy may be further amplified by the COVID-19 pandemic and warrant further study.
2019 年冠状病毒病（COVID-19）大流行扰乱了医疗保健服务，包括择期内镜检查。我们旨在确定 COVID-19 时代内镜检查取消的发生率，并确定与因大流行取消内镜检查相关的患者特征。
回顾了 2020 年 5 月至 2020 年 8 月期间取消门诊内镜检查的成年患者的病历。使用逻辑回归评估患者特征与因 COVID-19 取消内镜检查之间的关联。
共有 652 例内镜检查取消，其中 211 例（32%）因 COVID-19，384 例（59%）因非 COVID-19 原因，57 例（9%）原因不明。在与 COVID-19 相关的取消中，75 例（36%）与 COVID-19 检测物流有关，121 例（57%）与 COVID-19 恐惧有关，15 例（7%）与其他原因有关。在调整后的分析中，黑人患者因 COVID-19 取消的几率明显更高（OR 2.04，95%CI 1.07-3.88，p=0.03），而接受内镜检查（OR 0.56，95%CI 0.31-0.99，p=0.05）或高级内镜检查（OR 0.18，95%CI 0.07-0.49，p=0.001）的患者取消的几率较低。在 COVID-19 检测物流方面，黑人患者（OR 3.12，95%CI 1.03-9.46，p=0.05）和 Medi-Cal 保险患者（OR 2.89，95%CI 1.21-6.89，p=0.02）取消的几率明显更高。
黑人种族与 COVID-19 相关取消的风险增加有关。具体来说，黑人和 Medi-Cal 患者因获得内镜检查前 COVID-19 检测的物流而取消的风险增加。COVID-19 大流行可能进一步放大种族和社会经济差异获得内镜检查的机会，并需要进一步研究。
