Mahajan R J, Marshall J B
Division of Gastroenterology, University of Missouri Health Sciences Center, Columbia 65212, USA.
Gastrointest Endosc. 1997 Jul;46(1):21-6. doi: 10.1016/s0016-5107(97)70204-9.
Open-access endoscopy allows physicians who are not gastroenterologists to directly schedule patients for endoscopic procedures without having them first seen in the gastrointestinal clinic. We sought to determine the prevalence of open-access endoscopy in the United States and to examine endoscopists' attitudes toward the practice.
Questionnaires were mailed to a random sample of 1500 members of the American Society for Gastrointestinal Endoscopy. Out of 1460 that apparently reached the endoscopist, 577 (39.5%) were returned and analyzed.
Of the endoscopists who responded, 60.5% said that they offered some form of open-access endoscopy. Open-access endoscopy comprised less than 10% of outpatient endoscopic practice for 48.2% of individuals who reported they offered the service; it comprised over 25% of practice in 19.8%. Of those doing it, the procedures offered on an open-access basis included esophagogastroduodenoscopy 86.0%, colonoscopy 76.5%, flexible sigmoidoscopy 94.3%, ERCP 7.7%, and endoscopic ultrasonography 4.3%. For endoscopists not offering open-access endoscopy, the most important reasons were concern about performing "not indicated" procedures (85.1 %), medical-legal issues (65.8%), and failure to believe in the concept of open-access endoscopy (59.6%). Attitudes toward open access endoscopy were significantly different among endoscopists who did and did not practice it.
Open-access endoscopy, offered by more than 60% of the American endoscopists who responded to our survey, has become an important method of health care delivery in this country.
开放式内镜检查允许非胃肠病学医生的内科医生直接为患者安排内镜检查程序，而无需患者先在胃肠病诊所就诊。我们试图确定美国开放式内镜检查的普及程度，并调查内镜医师对这种做法的态度。
向美国胃肠内镜学会的1500名成员随机抽样邮寄调查问卷。在1460份显然送达内镜医师的问卷中，577份（39.5%）被返回并进行分析。
在回复的内镜医师中，60.5%表示他们提供某种形式的开放式内镜检查。对于48.2%报告提供该服务的个人来说，开放式内镜检查占门诊内镜检查业务的比例不到10%；在19.8%的业务中占比超过25%。在进行开放式内镜检查的人中，以开放式方式提供的检查程序包括食管胃十二指肠镜检查86.0%、结肠镜检查76.5%、乙状结肠镜检查94.3%、内镜逆行胰胆管造影7.7%和内镜超声检查4.3%。对于不提供开放式内镜检查的内镜医师来说，最重要的原因是担心进行“不必要”的检查（85.1%）、医疗法律问题（65.8%）以及不相信开放式内镜检查的概念（59.6%）。进行和不进行开放式内镜检查的内镜医师对其态度存在显著差异。
在回复我们调查的美国内镜医师中，超过60%提供开放式内镜检查，这已成为该国医疗服务的一种重要方式。
