Colonoscopy quality in community hospitals and nonhospital facilities in Korea
- Abstract
- Background/Aims
High-quality colonoscopy is essential to reduce colorectal cancer-related deaths. Little is known about colonoscopy quality in non-academic practice settings. We aimed to evaluate the quality of colonoscopies performed in community hospitals and nonhospital facilities.
Methods
Colonoscopy data were collected from patients referred to six tertiary care centers after receiving colonoscopies at community hospitals and nonhospital facilities. Based on their photographs, we measured quality indicators including cecal intubation rate, withdrawal time, adequacy of bowel preparation, and number of polyps.
Results
Data from a total of 1,064 colonoscopies were analyzed. The overall cecal intubation rate was 93.1%. The median withdrawal time was 8.3 minutes, but 31.3% of colonoscopies were withdrawn within 6 minutes. Community hospitals had longer withdrawal time and more polyps than nonhospital facilities (median withdrawal time: 9.9 minutes vs. 7.5 minutes, p < 0.001; mean number of polyps: 3.1 vs. 2.3, p = 0.001). Board-certified endoscopists had a higher rate of cecal intubation than non-board-certified endoscopists (93.2% vs. 85.2%, p = 0.006). A total of 819 follow-up colonoscopies were performed at referral centers with a median interval of 28 days. In total, 2,546 polyps were detected at baseline, and 1,088 were newly identified (polyp miss rate, 29.9%). Multivariable analysis revealed that older age (odds ratio [OR], 1.032; 95% confidence interval [CI], 1.020 to 1.044) and male sex (OR, 1.719; 95% CI, 1.281 to 2.308) were associated with increased risk of missed polyps.
Conclusions
The quality of colonoscopies performed in community hospitals and nonhospital facilities was suboptimal. Systematic reporting, auditing, and feedback are needed for quality improvement.
- All Author(s)
- J. G. Lee
; D. S. Han
; Y. E. Joo
; D. S. Myung
; D. I. Park
; S. K. Kim
; Y. Jung
; W. H. Lee
; E. S. Kim
; J. S. Yoon
; C. S. Eun
- Issued Date
- 2021
- Type
- Article
- Keyword
- Colonoscopy; Quality improvement; Community hospital; Ambulatory care facilities
- Publisher
- 대한내과학회
Korean Association of Internal Medicine
- ISSN
- 1226-3303
; 2005-6648
- Citation Title
- The Korean journal of internal medicine
- Citation Volume
- 36
- Citation Number
- Suppl 1
- Citation Start Page
- S35
- Citation End Page
- S43
- Language(ISO)
- eng
- DOI
- 10.3904/kjim.2019.117
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/3225
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