Keeping The Endoscopy Ship Afloat Against The First Wave Of Covid -19 -The Utilisation Of A Private Institution To Bolster Mmuh Gi Services During Covid-19

Aims During COVID-19, guidelines for performance of endoscopy meant procedure numbers were significantly curtailed. From April-June 2020, the Health Authorities in Ireland procured private hospitals for public use.

The aims of this study were

1. to determine if additional private hospital capacity was utilised effectively for endoscopy, as this model is often employed to deal with long waiting lists in Ireland.

2. to compare pathology and follow up rates between the two institutions.

Methods We analysed all documentation relating to 242 endoscopy procedures outsourced to the private institution (MPH).

For the period of June 2020 we compared indications, follow up rates and pathology for outpatient endoscopy procedures performed in our public institution, MMUH (n = 111) and MPH (n = 104).

Results 197/242 (81.4 %) procedures in 167 patients were completed. Non-completion was due to refusal or failure to attend (32) and illness (6). 102 patients (61 %) were subsequently discharged to the GP and 39 % of patients required hospital follow up.

There was no significant difference between indications in both institutions (p = 0.843). As shown in Table 1, rates of significant pathology in MPH vs MMUH were not statistically significant, 4 % vs 7 %; p = 0.315. There was no difference in follow up rates in MPH vs MMUH, 62 % vs 51 %, p = 0.849.

Tab. 1 Significant pathology on urgent outpatient endoscopy procedures between MPH(private institution) and MMUH in June 2020

Significant Pathology	MPH (n = 104)	MMUH (n = 111)
New IBD	2	2
Ulcers	1	4
Upper GI cancers	0	2
Lower GI cancers	1	0

Conclusions The use of private capacity in MPH during the first wave of COVID19 significantly reduced the burden on the public system for GI procedures. However arranging the necessary follow up for the 39 % of patients from the MPH generated a substantial clinical and administrative workload on the public system.

Although the endoscopy procedures performed in both institutions were deemed ‘urgent’, significant pathology was rare, between 4-7 %, suggesting more stringent criteria for endoscopy should be considered in the future.

Citation Kerr H, Byrne MC, Cudmore J et al. eP491 KEEPING THE ENDOSCOPY SHIP AFLOAT AGAINST THE FIRST WAVE OF COVID -19 -THE UTILISATION OF A PRIVATE INSTITUTION TO BOLSTER MMUH GI SERVICES DURING COVID-19. Endoscopy 2021; 53: S260.

Publication History

Article published online:
19 March 2021