Division of Gastroenterology, Department of Medicine, Houston Methodist Lynda K. and David M. Underwood Center for Digestive Disorders, Houston Methodist, 6550 Fannin, Smith Tower Suite 1201, Houston, TX, 77030, USA.
Weill-Cornell Medical School, New York, NY, USA.
Dig Dis Sci. 2023 Jun;68(6):2303-2314. doi: 10.1007/s10620-023-07911-7. Epub 2023 Mar 16.
After COVID-19 restrictions on nonessential procedures were lifted and safety protocols established, utilization rates of endoscopic procedures remained reduced.
This study assessed patient attitudes and barriers to scheduling endoscopy during the pandemic.
A survey was administered to patients with ordered procedures at a hospital-based setting (7/21/2020-2/19/2021) collecting demographic data, body mass index, COVID-19 relevant comorbidities, level of procedural urgency (defined by recommended scheduling window), scheduling and attendance, concerns, and awareness of safety measures.
The average respondent was female (63.8%), age 57.6 ± 14, White (72.3%), married (76.7%), insured (99.3%), affluent English speakers (92.3%) and highly educated (at least college 90.2%). Most reported moderate to excellent COVID-19 knowledge (96.6%). Of 1039 procedures scheduled, emergent cases accounted for 5.1%, urgent 55.3% and elective 39.4%. Respondents identified appointment convenience (48.53%) as the most frequent factor impacting scheduling, also noting concern for results (28.4%). Age (p = .022), native language (p = .04), education (p = .007), self-reported COVID knowledge (p = .002), and a desire to be COVID tested pre-procedure (p = .023) were associated with arrival, more commonly in an ambulatory surgical center than hospital (p = .008). Diabetes mellitus (p = .004) and an immunocompromised state (p = .009) were adversely related to attendance. Attitudes towards safety protocols did not affect scheduling. Multivariate analysis demonstrated age, education and COVID knowledgeability were associated with procedure completion.
Safety protocols and urgency levels were not associated with procedure completion. Pre-pandemic barriers to endoscopy persisted as dominant factors amid pandemic concerns.
在取消了针对非必要程序的 COVID-19 限制并建立了安全协议之后，内窥镜程序的使用率仍然较低。
本研究评估了大流行期间患者安排内窥镜检查的态度和障碍。
在医院环境中（2020 年 7 月 21 日至 2021 年 2 月 19 日）对接受预定程序的患者进行了一项调查，收集人口统计学数据、体重指数、与 COVID-19 相关的合并症、程序紧迫性程度（按推荐的预约窗口定义）、预约和出席情况、关注事项以及对安全措施的认识。
平均受访者为女性（63.8%），年龄 57.6±14 岁，白人（72.3%），已婚（76.7%），有保险（99.3%），讲流利英语（92.3%）且受过高等教育（至少大学毕业 90.2%）。大多数人报告了中度到高度的 COVID-19 知识（96.6%）。在预定的 1039 个程序中，紧急情况占 5.1%，紧急情况占 55.3%，择期情况占 39.4%。受访者认为预约的便利性（48.53%）是影响预约的最常见因素，也对结果表示担忧（28.4%）。年龄（p=.022）、母语（p=.04）、教育程度（p=.007）、自我报告的 COVID 知识（p=.002）以及术前进行 COVID 检测的意愿（p=.023）与到达情况相关，更常见的是在门诊手术中心而不是医院（p=.008）。糖尿病（p=.004）和免疫功能低下状态（p=.009）与出席情况呈负相关。对安全协议的态度并未影响预约。多变量分析表明，年龄、教育程度和 COVID 知识与手术完成情况相关。
安全协议和紧急程度与手术完成情况无关。大流行前内窥镜检查的障碍仍然是大流行期间的主要因素。
