Anesthesia Service Use and the Uptake of Screening Colonoscopies

Hirshman, Samuel; Mattke, Soeren; Liu, Henry

doi:10.1097/mlr.0000000000000690

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…In fact, Medicare covers anesthesia costs for screening colonoscopies without any deductibles. This policy was intended to increase the uptake of colon cancer screening, despite studies showing that anesthesia use is not associated with any increase in screening rates, 80 but will increase costs. 81 In situations where insurance coverage for anesthesia is denied, patients are charged directly.…”

Section: Computer-assisted Propofol Sedationmentioning

confidence: 99%

Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction

Lin

2017

Intest Res

101

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Most gastrointestinal endoscopic procedures are now performed with sedation. Moderate sedation using benzodiazepines and opioids continue to be widely used, but propofol sedation is becoming more popular because its unique pharmacokinetic properties make endoscopy almost painless, with a very predictable and rapid recovery process. There is controversy as to whether propofol should be administered only by anesthesia professionals (monitored anesthesia care) or whether properly trained non-anesthesia personnel can use propofol safely via the modalities of nurse-administered propofol sedation, computer-assisted propofol sedation or nurse-administered continuous propofol sedation. The deployment of non-anesthesia administered propofol sedation for low-risk procedures allows for optimal allocation of scarce anesthesia resources, which can be more appropriately used for more complex cases. This can address some of the current shortages in anesthesia provider supply, and can potentially reduce overall health care costs without sacrificing sedation quality. This review will discuss efficacy, safety, efficiency, cost and satisfaction issues with various modes of sedation for non-advanced, non-emergent endoscopic procedures, mainly esophagogastroduodenoscopy and colonoscopy.

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Section: Computer-assisted Propofol Sedationmentioning

confidence: 99%

Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction

Lin

2017

Intest Res

101

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“…One of the factors influencing the quality of endoscopy examination is sedation. Several studies on colonoscopy have suggested that sedation improves adenoma detection ( 16), but the evidence is inconsistent (17)(18)(19)(20)(21). Few studies have focused on the association between AA and the rate of lesion detection in patients undergoing EGD screening.…”

Section: Discussionmentioning

confidence: 99%

Effect of anesthesia assistance on the detection rate of precancerous lesions and early esophageal squamous cell cancer in esophagogastroduodenoscopy screening: A retrospective study based on propensity score matching

Liang

Xu²,

Zhang³

et al. 2023

Front. Med.

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BackgroundEsophagogastroduodenoscopy (EGD) screening is vital for the early diagnosis of esophageal squamous cell cancer (ESCC). However, improvement in the detection rate of precancerous lesions and early ESCC with anesthesia assistance (AA) has not yet been investigated. This retrospective study aimed to evaluate the effect of AA on the detection rate of precancerous lesions and early ESCC in patients undergoing EGD screening and identify risk factors affecting the detection rate.MethodsWe reviewed patients’ electronic medical records who underwent EGD screening between May 2019 and August 2020. Patients were divided into two groups based on whether they received AA: those in Group A underwent EGD screening with AA, and patients in Group O underwent EGD screening without AA. Propensity score matching (PSM) was used to account for differences in baseline characteristics. Detection rates of precancerous lesions and early ESCC were compared between the two groups following PSM. Binary logistic regression was used to identify risk factors affecting the detection rate.ResultsThe final analysis included 21,835 patients (Group A = 13,319, Group O = 8,516) from 28,985 patients who underwent EGD screening during the study period. Following PSM, 6009 patients remained in each group for analysis. There was no significant difference in the detection rate of precancerous lesions and early ESCC between Groups A and O (1.1% vs. 0.8%, p > 0.05). Binary logistic regression showed that age (50–59 years, 60–69 years and 70–79 years), higher endoscopist seniority, high-definition (HD) endoscopy, narrow-band imaging (NBI), and number of endoscopic images were all independent risk factors that affected the detection rate of precancerous lesions and early ESCC.ConclusionThere was no statistically significant difference in the detection rate of precancerous lesions and early ESCC between patients who underwent EGD screening with and without AA. All independent risk factors that affected the detection rate of precancerous lesions and early ESCC included the following: age (50–59 years, 60–69 years and 70–79 years), higher endoscopist seniority, HD endoscopy, NBI, and number of endoscopic images. Endoscopists should consider all these factors as much as possible when performing EGD screening.

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“…51,52 In contrast, providing mere financial incentives resulted in a modest if any increase in CRC screening uptake. 12,[62][63][64]…”

Section: Facilitatementioning

confidence: 99%

How to Ensure Patient Adherence to Colorectal Cancer Screening and Surveillance in Your Practice

Hassan

Repici

2018

Gastroenterology

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Anesthesia Service Use and the Uptake of Screening Colonoscopies

Abstract: No significant association between anesthesia service use and colonoscopy screening or colorectal cancer screening rates was found, suggesting that more evidence is needed to support the Center for Medicare & Medicaid Services rule change.

Cited by 4 publications

References 14 publications

Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction

Sedation for routine gastrointestinal endoscopic procedures: a review on efficacy, safety, efficiency, cost and satisfaction

Effect of anesthesia assistance on the detection rate of precancerous lesions and early esophageal squamous cell cancer in esophagogastroduodenoscopy screening: A retrospective study based on propensity score matching

How to Ensure Patient Adherence to Colorectal Cancer Screening and Surveillance in Your Practice

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