Patterns of endoscopy in the United States: analysis of data from the Centers for Medicare and Medicaid Services and the National Endoscopic Database

Gastrointestinal Endoscopy
Amnon SonnenbergDavid A Lieberman

Abstract

Patterns of GI endoscopy are influenced by the underlying epidemiology of GI disease, as well as by policy and practice guidelines. To compare practice patterns of GI endoscopy between two large national databases of the United States. Descriptive database analysis. A 5% sample of the entire U.S. Medicare population (Centers for Medicare and Medicaid Services, CMS data files) and endoscopic data repository of U.S. gastroenterology practices (Clinical Outcomes Research Initiative, CORI database) from 1999 to 2003. The study population included 1,121,215 Medicare and 635,573 CORI patients undergoing various types of GI endoscopy. EGD, colonoscopy, and flexible sigmoidoscopy. Patient demographics, endoscopic diagnoses, time trends of diagnoses. A colonoscopy was the most common endoscopic procedure performed (CMS 53%, CORI 58%), followed by an EGD (37%, 32%), and a flexible sigmoidoscopy (10%, 10%). In the CMS data, women accounted for 59% of the EGDs, 57% of the colonoscopies, and 56% of the flexible sigmoidoscopies, and in the CORI data, the corresponding numbers were 57%, 55%, and 54%, respectively. Compared with their distribution in the U.S. census population, nonwhite patients in both databases underwent relatively more EGDs...Continue Reading

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