Endoscopy 2001; 33(8): 662-667
DOI: 10.1055/s-2001-16223
Original Article

© Georg Thieme Verlag Stuttgart · New York

An Assessment of the Potential Value of Endoscopic Ultrasound as a Cost-Minimizing Tool in Dyspeptic Patients with Persistent Symptoms

A. V. Sahai, I. D. Penman, G. Mishra, D. Williams, A. Pearson, M. B. Wallace, A. van Velse, B. J. Hoffman, R. H. Hawes
  • Division of Gastroenterology and Hepatology/Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina, USA
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
31. Dezember 2001 (online)

Study Aims: To quantify resource utilization in dyspeptic patients with persistent symptoms and to determine whether using both the endoscopic and ultrasound capabilities of endoscopic ultrasound could reduce costs.

Methods: Consecutive patients with persistent dyspepsia, after a minimum 1-month trial of acid suppression, underwent endoscopic ultrasound (EUS) and upper endoscopy using the GF-UM20 echo endoscope. Assuming EUS could replace imaging tests which had been requested in addition to upper endoscopy, the hypothetical costs of the EUS-based and upper endoscopy-based strategies were compared.

Results: 116 patients with persistent dyspepsia underwent EUS, of whom 64.6 % had ≥ 2 imaging procedures, most commonly computed tomography (CT) (70.6 %) and abdominal ultrasound (64.7 %). The number of tests did not correlate strongly with any demographic variables. The fiberoptic echo endoscope provided an adequate endoscopic and ultrasound examination but was damaged by retroflexion. Direct hospital costs were lowest for the EUS-based strategy. Total avoidable cost for 116 patients was $ 4137 to $ 14 121 (or $ 36 to $ 122 per patient), depending on whether upper endoscopy was performed in the non-EUS strategies.

Conclusions: Patients with persistent dyspepsia may undergo multiple abdominal imaging procedures. Clinical variables do not predict the need for additional testing. An EUS-based strategy may reduce overall costs if it prevents additional testing.

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A. V. Sahai,M.D. 

Département de Gastroentérologie
CHUM, Campus St Luc

1058 Rue Saint Denis
Montréal, Québec H2X 3J4
Canada


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