如何提高门诊胃肠内镜的适宜性：COVID-19 疫情的教训。

How we can improve the appropriateness of ambulatory gastrointestinal endoscopy: the lesson of the COVID-19 outbreak.

机构信息

Territorial Gastroenterology Service, ASL BAT, Andria (BT).

Department of Medical and Surgical Sciences, School of Medicine, Catholic University, Rome.

出版信息

Eur J Gastroenterol Hepatol. 2023 Oct 1;35(10):1149-1153. doi: 10.1097/MEG.0000000000002626. Epub 2023 Jul 28.

DOI:10.1097/MEG.0000000000002626

PMID:37665614

Abstract

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak has significantly modified hospital and outpatient activities.

AIMS

To assess the pandemic's impact on the appropriateness of outpatient gastrointestinal (G.I.) endoscopy in a southern Italy Region.

METHODS

Between 1 January 2019 and 31 December 2022, we compared the number, the type of activities, and the appropriateness of the G.I. endoscopy procedures in the four territorial gastroenterology and digestive endoscopy services of the Apulia region.

RESULTS

In 2019, 11 173 outpatient procedures were provided, which dropped by about 44% (P < 0.05) during 2020. The endoscopic activity was slightly reduced during 2020 (-18.77%), while every other activity dropped significantly. During 2021-2022, the overall activities slightly increased but remained below the number of activities provided before the pandemic (P < 0.05). However, the endoscopic activity increased by +6.86% from 2019 to 2022, mainly due to more colonoscopies. During the 4 years analysed, the overall appropriateness rate of the endoscopic examinations increased during 2020 (2019: 67%; 2020: 81%) while dropping again in the following years (2021: 75%; 2022; 69%).

CONCLUSION

The appropriateness of the G.I. endoscopic procedures in the territorial gastroenterology services in the Apulia Region has improved during the acute phase of the COVID-19 pandemic, dropping again in the following years. Overall, the appropriateness of endoscopic procedures remains suboptimal; thus, educational activities are needed to improve the appropriateness rate to optimise the limited resources.

摘要

背景

2019 年冠状病毒病（COVID-19）疫情极大地改变了医院和门诊活动。

目的

评估该疫情对意大利南部地区门诊胃肠道（GI）内镜检查的适宜性的影响。

方法

在 2019 年 1 月 1 日至 2022 年 12 月 31 日期间，我们比较了普利亚大区四个地区性胃肠病学和消化内镜服务中心的 GI 内镜检查数量、类型和适宜性。

结果

2019 年提供了 11173 例门诊检查，2020 年下降了约 44%（P<0.05）。内镜活动在 2020 年略有减少（-18.77%），而其他活动则显著下降。在 2021-2022 年期间，整体活动略有增加，但仍低于疫情前的活动数量（P<0.05）。然而，内镜活动从 2019 年到 2022 年增加了+6.86%，主要是由于结肠镜检查的增加。在分析的 4 年中，2020 年内镜检查的总体适宜率增加（2019 年：67%；2020 年：81%），随后在随后的几年中再次下降（2021 年：75%；2022 年：69%）。