Summary of the 2024 report on gastroenterology and digestive endoscopy in China

Abstract

Background: China has made significant progress in medical accessibility and quality over the past decades, and quality improvements in gastroenterology and digestive endoscopy have been consistent. The study aimed to describe the status quo of gastroenterology and digestive endoscopy in the Chinese mainland based on the data from the National Clinical Improvement System (NCIS) and the Hospital Quality Monitoring System (HQMS).

Methods: Data were extracted from the NCIS and the HQMS. Data analysis included general information from the Department of Gastroenterology and Endoscopy centers, management of inpatients and outpatients, and annual volume and quality indicators of digestive endoscopy. Acute pancreatitis, gastrointestinal bleeding, inflammatory bowel disease, and cirrhosis were identified as priority diseases and were subjected to detailed analysis.

Results: Data from 4620 and 7074 hospitals were extracted from the NCIS and HQMS, respectively. In 2023, 9.6 gastroenterologists, 6.7 endoscopists, and 37.3 gastroenterology beds per hospital nationwide were observed, achieving 19,252.4 outpatient visits, 1615.2 hospitalizations (97.0 for acute pancreatitis, 146.1 for gastrointestinal bleeding, 40.2 for inflammatory bowel disease, and 111.4 for cirrhosis), and 9432.7 digestive endoscopic procedures per hospital. Overall, the quality of practice improved significantly. The proportion of early cancer among gastrointestinal cancers increased from 11.1% in 2015 to 23.4% in 2023, and the adenoma detection rate during colonoscopy increased from 19.3% in 2019 to 26.9% in 2023. Regarding priority diseases, hospitalizations increased, and 31-day unplanned readmission rates decreased between 2019 and 2023. The median hospitalization costs and median proportion of medication costs decreased for acute pancreatitis, gastrointestinal bleeding, and cirrhosis. However, it increased for inflammatory bowel disease.

Conclusion: This report evaluates the status quo and development of gastroenterology and digestive endoscopy in the Chinese mainland, providing guidance for future quality improvements.

Keywords: Digestive diseases; Digestive endoscopy; Gastroenterology; Health care surveys; Quality improvement; Quality indicator.

Figure 1

Characteristics of hospitalizations in tertiary hospitals in 2019 and 2023. (A) Inpatient volume per hospital of priority diseases in tertiary hospitals. (B) The median length of stay of priority diseases in tertiary hospitals. (C) The 31-day unplanned readmission rate of priority diseases in tertiary hospitals. (D) The median costs of hospitalization of priority diseases in tertiary hospitals. (E) The median proportion of medication costs of priority diseases in tertiary hospitals. (F) The median proportion of antimicrobial medication of priority diseases in tertiary hospitals. GI: Gastrointestinal bleeding; IBD: Inflammatory bowel disease.

Figure 2

Characteristics of hospitalizations in secondary hospitals in 2019 and 2023. (A) Inpatient volume per hospital of priority diseases in secondary hospitals. (B) The median length of stay of priority diseases in secondary hospitals. (C) The 31-day unplanned readmission rate of priority diseases in secondary hospitals. (D) The median costs of hospitalization of priority diseases in secondary hospitals. (E) The median proportion of medication costs of priority diseases in secondary hospitals. (F) The median proportion of antimicrobial medication for priority diseases in secondary hospitals. GI: Gastrointestinal bleeding; IBD: Inflammatory bowel disease.

Figure 3

The proportion of early cancer among gastrointestinal cancers in endoscopy in China, 2015–2023.