A study published in Gastroenterology examines the colonoscopy quality among different facilities.
The researchers used a 20 percent sample Medicare outpatient claims that included 331,880 colonoscopies performed at 8,140 facilities for patients who were 65 years or older. The researchers found:
1. There were 5,412 unplanned hospital visits within one week after the outpatient colonoscopy.
2. The most common reasons for the unplanned hospital visits were hemorrhage, abdominal pain and perforation.
3. The independent variables associated with unplanned hospital visits included:
• History of fluid and electrolyte imbalance
• Psychiatric disorders
• In the absence of prior arrhythmia, age older than 65 years
4. The facility risk-standardized unplanned hospital visits showed a significant cost variation.
5. The median risk-standardized unplanned hospital visits comparable between ambulatory surgery centers and hospital outpatient departments ranged from 16.1 per 1,000 in the Northeast to 17.2 per 1,000 in the Midwest.
6. The researchers concluded the measure they developed could show which patients require follow-up hospital care and help inform patients' choices as well as quality improvement efforts.
The patient-level risk model variables and hierarchical logistic regression the researchers used estimated facility rates of risk-standardized unplanned hospital visits with data from the Healthcare Cost and Utilization Project for four states with 325,811 colonoscopies at 992 facilities.