Evaluation of Colonoscopy Capacity in New York City

1
Evaluation of Colonoscopy Capacity in New York
City

• New York City Department of Health and Mental
  Hygiene
• Jennifer Leng MD, MPH

2
Strategies and accomplishments 2003 - 2004

• 1. One-time citywide survey of all hospital-based
  suites, 2003 (for 2002 data)
• - Accepted publication of above results
• in Preventing Chronic Disease
• 2. Quarterly colonoscopy capacity surveillance
  system 2003 present
• 3. One-time survey of outpatient offices in
  selected neighborhoods prelim results
• 4. Future availability of data from all endoscopy
  suites CDC survey

3
1. Citywide survey, 2003 (for 2002 data)
Hospitals contacted
69

Hospitals performing colonoscopy
66
Additional affiliated hospitals/clinics
2
Endoscopy clinics surveyed
68
Non-HHC
HHC
Type of endoscopy clinic
N57
N11
11
55
Inpatient and outpatient
2
Outpatient, free-standing
0
One hospital was a hospital center consisting
of 2 separate hospital units this was analyzed
as one hospital One hospital used both an
inpatient/outpatient suite and an operating room
to perform colonoscopy exams
4
1. Citywide survey, 2003 (for 2002 data), N68

• Reported of exams performed
• 126,000
• Estimated performed for screening
• 53,600
• Estimated annual max of exams
• 195,200
• Unused capacity
• 69,100

Three hospitals responded "don't know"
Data missing from three hospitals
Six hospitals responded dont know Note
Values were rounded to the nearest hundred
5
Screening colonoscopy capacity at 68 endoscopy
clinics in NYC by borough
6
2. Quarterly colonoscopy capacity surveillance
system 2003 - present
All endoscopy clinics
Non-HHC
HHC
N66
N55
N11
Total colonoscopies
Average of Q2-4, 2003
36,636
33,432
3,204
Q1, 2004
35,576
31,627
3,949
8 Increase
Q2, 2004
39,739
35,184
4,555
7
3. One-time survey of outpatient offices in
selected neighborhoods prelim results

• DOHMH wanted to learn more about the volume of
  procedures performed in the outpatient office
  setting
• Surveyed GI physicians in underserved areas,
  within the 3 DPHO zip codes
• Surveyed GI physicians in 3 non-DPHO comparison
  areas, northeast Queens, northern SI, upper east
  side

8
3. One-time survey of outpatient offices in
selected neighborhoods prelim results, contd

• Prelim results
• - 248 GI docs in 6 selected areas
• - 150 contacted who perform CS
• - 61 (41) perform office CS
• - 9 surveys recd (represents 22 docs)
• Prelim conclusions
• - Ongoing outpatient survey not feasible
• - Data limited
• - If 50 of citywide CS done in hospitals,
  quarterly hospital-based survey likely is
  feasible method to follow CS volume

9
4. Future availability of colonoscopy data from
all suites CDC survey

• CDC conducting a one-time survey of all endoscopy
  suites in NY state
• Will provide DOHMH with neighborhood level data
• Will enable DOHMH to compare hospital-based data
  with the universe

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Conclusions/Next Steps

• Continue work to improve physician and patient
  awareness to increase screening rates
• Develop institutional measures to expedite and
  encourage CS
• Continue hospital-based quarterly surveillance to
  measure progress