The Gastropack Access System as a Model to Access Gastroenterology Services for Gastroscopy Appropriateness in Patients with Upper Gastrointestinal Symptoms: A Comparison with the Open Access System.

endoscopy general practice guidelines shared medicine

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
08 May 2023
Historique:
received: 27 03 2023
revised: 16 04 2023
accepted: 03 05 2023
medline: 13 5 2023
pubmed: 13 5 2023
entrez: 13 5 2023
Statut: epublish

Résumé

Esophagogastroduodenoscopy (EGD) appropriateness in Open-Access System (OAS) is a relevant issue. The Gastropack Access System (GAS) is a new system to access gastroenterological services, based on the partnership between Gastroenterologists and GPs. This study aims to evaluate if GAS is superior to OAS in terms of EGDS appropriateness. Secondarily, we evaluated the diagnostic yield of EGDS according to ASGE guidelines. The GAS was developed in an area of Bologna where General Practitioners (GPs) could decide to directly prescribe EGDS through OAS or referring to GAS, where EGDS can be scheduled after contact between GPs and specialists sharing a patient's clinical information. Between 2016 and 2019, 2179 cases (M:F = 861:1318, median age 61, IQR 47.72) were referred to GAS and 1467 patients (65%) had a prescription for EGDS; conversely, 874 EGDS were prescribed through OAS (M:F = 383:491; median age 58 yrs, IQR 45.68). Indication was appropriate in 92% in GAS (1312/1424) versus 71% in OAS (618/874),

Identifiants

pubmed: 37176783
pii: jcm12093343
doi: 10.3390/jcm12093343
pmc: PMC10178877
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

BMC Health Serv Res. 2013 Dec 20;13:528
pubmed: 24359610
Gastrointest Endosc. 2004 Apr;59(4):517-24
pubmed: 15044888
Gastrointest Endosc. 2002 Nov;56(5):714-9
pubmed: 12397281
Dig Liver Dis. 2019 Mar;51(3):335-339
pubmed: 30583999
Gastrointest Endosc. 2012 Jun;75(6):1127-31
pubmed: 22624807
Br J Gen Pract. 1998 Apr;48(429):1165-6
pubmed: 9667095
Euroasian J Hepatogastroenterol. 2016 Jul-Dec;6(2):143-148
pubmed: 29201747
Qual Saf Health Care. 2007 Feb;16(1):67-70
pubmed: 17301208
GE Port J Gastroenterol. 2021 May 25;29(1):5-12
pubmed: 35111959
Dig Liver Dis. 2001 Jan-Feb;33(1):75-80
pubmed: 11303980
BMJ Open. 2018 Feb 11;8(2):e018557
pubmed: 29440142
Can J Gastroenterol. 2011 Feb;25(2):83-8
pubmed: 21321679
Gastrointest Endosc Clin N Am. 2006 Oct;16(4):709-17
pubmed: 17098617
Digestion. 2005;72(1):1-7
pubmed: 16088146
World J Gastroenterol. 2019 Jan 14;25(2):178-189
pubmed: 30670908
Gastrointest Endosc. 2015;81(6):1326-9
pubmed: 25865387
Gastroenterology. 2018 May;154(7):1993-2003
pubmed: 29454789
United European Gastroenterol J. 2022 Jul;10(6):556-584
pubmed: 35695704
Dig Liver Dis. 2010 Feb;42(2):122-6
pubmed: 19497799
Surgeon. 2013 Dec;11(6):304-8
pubmed: 23510705
Gastrointest Endosc. 2006 Oct;64(4):565-9
pubmed: 16996351
Dig Liver Dis. 2023 Feb;55(2):187-207
pubmed: 36517261
Gastrointest Endosc. 2007 May;65(6):767-74
pubmed: 17466196
BMC Health Serv Res. 2018 Dec 20;18(1):986
pubmed: 30572898
Aliment Pharmacol Ther. 2002 Jan;16(1):105-10
pubmed: 11856084
World J Gastroenterol. 2015 Feb 21;21(7):2152-8
pubmed: 25717251
Br J Gen Pract. 2003 Feb;53(487):94-100
pubmed: 12817353
Gastrointest Endosc. 2022 Aug;96(2):184-188.e4
pubmed: 35680470
Scand J Gastroenterol. 2009;44(4):491-8
pubmed: 19031302
Gastrointest Endosc. 2000 Sep;52(3):333-41
pubmed: 10968846

Auteurs

Liza Ceroni (L)

Department of Gastroenterology and Interventional Endoscopy, AUSL Bologna Bellaria, Maggiore Hospital Bologna, 40133 Bologna, Italy.

Francesca Lodato (F)

Department of Gastroenterology and Interventional Endoscopy, AUSL Bologna Bellaria, Maggiore Hospital Bologna, 40133 Bologna, Italy.

Paolo Tubertini (P)

Process Reengineering, AUSL Bologna, 40124 Bologna, Italy.
Enterprise Information Systems for Integrated Care and Research Data Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.

Giovanni Marasco (G)

IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40126 Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy.

Alessia Gazzola (A)

Department of Gastroenterology and Interventional Endoscopy, AUSL Bologna Bellaria, Maggiore Hospital Bologna, 40133 Bologna, Italy.

Maurizio Biselli (M)

Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy.
Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40126 Bologna, Italy.

Cristiano Fabbri (C)

Process Reengineering, AUSL Bologna, 40124 Bologna, Italy.
Enterprise Information Systems for Integrated Care and Research Data Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.

Federica Buonfiglioli (F)

Department of Gastroenterology and Interventional Endoscopy, AUSL Bologna Bellaria, Maggiore Hospital Bologna, 40133 Bologna, Italy.

Francesco Ferrara (F)

Department of Gastroenterology and Interventional Endoscopy, AUSL Bologna Bellaria, Maggiore Hospital Bologna, 40133 Bologna, Italy.

Ramona Schiumerini (R)

Department of Gastroenterology and Interventional Endoscopy, AUSL Bologna Bellaria, Maggiore Hospital Bologna, 40133 Bologna, Italy.

Andrea Fabbri (A)

IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40126 Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy.

Alessandra Tassoni (A)

Program for Clinical Governance and Outpatients Care, AUSL Bologna, 40124 Bologna, Italy.

Carlo Descovich (C)

Department of Clinical Governance and Quality, AUSL Bologna, 40124 Bologna, Italy.

Sandra Mondini (S)

Department of Primary Care, Distretto Appennino Bolognese, AUSL Bologna, 40124 Bologna, Italy.

Cesare Tosetti (C)

Department of Primary Care, Distretto Appennino Bolognese, AUSL Bologna, 40124 Bologna, Italy.

Valerio Veduti (V)

Department of Primary Care, Distretto Appennino Bolognese, AUSL Bologna, 40124 Bologna, Italy.

Mario De Negri (M)

Department of Primary Care, Distretto Appennino Bolognese, AUSL Bologna, 40124 Bologna, Italy.

Alessandro Fini (A)

Department of Primary Care, Distretto Appennino Bolognese, AUSL Bologna, 40124 Bologna, Italy.

Stefano Guicciardi (S)

Medical Direction, AUSL Bologna, 40124 Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy.

Massimo Romanelli (M)

E-Care Processes Unit, AUSL Bologna, 40124 Bologna, Italy.

Giuseppe Giovanni Navarra (GG)

General Surgery, Distretto Appennino Bolognese, AUSL Bologna, 40124 Bologna, Italy.

Giovanni Barbara (G)

IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40126 Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy.

Vincenzo Cennamo (V)

Department of Gastroenterology and Interventional Endoscopy, AUSL Bologna Bellaria, Maggiore Hospital Bologna, 40133 Bologna, Italy.

Classifications MeSH