Zhou Siwei, Chen Zheran, Jiao Yunfei, Cheng Zhiyuan, Gao Ye, Wang Tianjiao, Xin Lei, Wan Rong, Wang Luowei
Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China.
National Digestive Endoscopy Improvement System, Shanghai, China.
Front Oncol. 2024 Jun 7;14:1366706. doi: 10.3389/fonc.2024.1366706. eCollection 2024.
Given the significant burden of upper digestive diseases, there has been a substantial increase in the utilization of esophagogastroduodenoscopy (EGD) in China from 2012 to 2019. The objective of this study is to investigate the development, practice, and factors influencing the widespread use of EGD during this period.
Two national censuses were conducted among all hospitals in mainland China that perform gastrointestinal endoscopy. These censuses aimed to extract information on the infrastructure, volume, and quality of EGD. The analysis of potential factors influencing EGD practice was based on real-world data from open access sources.
From 2012 to 2019, the number of hospitals performing EGD in mainland China increased from 1,518 to 2,265 (1.49-fold) in tertiary hospitals and from 3,633 to 4,097 (1.12-fold) in secondary hospitals, respectively. The national utilization rate of EGD also increased from 1,643.53 to 2,018.06 per 100,000 inhabitants, indicating a 1.23-fold increase. Regions with more endoscopists per 100,000 inhabitants (OR 9.61, <0.001), more tertiary hospitals performing EGD per million inhabitants (OR 2.43, <0.001), higher incidence of esophageal and gastric cancer (OR 2.09, =0 016), and higher number of hospitals performing EGD per million inhabitants (OR 1.77, =0.01) tended to provided more numerous and qualitied EGD. And hospital grading, regional GDP, incidence of esophageal and gastric cancer and the volume of EGD were observed as the significantly relevant factors of malignant dictation rate (MDR) (<0.05), but not the number and educational background of endoscopists.
Over the past seven years, China has made significant progress in EGD. However, challenges persist in terms of quality and inequality.
鉴于上消化道疾病的沉重负担，2012年至2019年期间中国食管胃十二指肠镜检查（EGD）的使用量大幅增加。本研究的目的是调查这一时期EGD的发展、实践情况以及影响其广泛使用的因素。
对中国大陆所有开展胃肠内镜检查的医院进行了两次全国普查。这些普查旨在提取有关EGD的基础设施、数量和质量的信息。对影响EGD实践的潜在因素的分析基于来自开放获取来源的真实世界数据。
从2012年到2019年，中国大陆开展EGD的三级医院数量从1518家增加到2265家（增长1.49倍），二级医院数量从3633家增加到4097家（增长1.12倍）。EGD的全国使用率也从每10万居民1643.53例增加到2018.06例，增长了1.23倍。每10万居民中内镜医师较多的地区（比值比9.61，<0.001）、每百万居民中开展EGD的三级医院较多的地区（比值比2.43，<0.001）、食管癌和胃癌发病率较高的地区（比值比2.09，=0.016）以及每百万居民中开展EGD的医院数量较多的地区（比值比1.77，=0.01）往往能提供更多且质量更高的EGD。并且观察到医院分级、地区国内生产总值、食管癌和胃癌发病率以及EGD数量是恶性诊断率（MDR）的显著相关因素（<0.05），但不是内镜医师的数量和教育背景。
在过去七年中，中国在EGD方面取得了显著进展。然而，在质量和不平等方面仍然存在挑战。
