[Gastroenterologic-endoscopic studies in ambulatory practice. Spectrum of applications, trends, quality and economic aspects]

Abstract

A review on spectrum, frequency and complication rate of gastroenterological endoscopy in ambulant practice is given based on data of the National Association of Public Health Insurance Physicians of Germany. The following important aspects are mentioned: 1. Endoscopy has surpassed radiology in diagnostic examinations for gastric and colonic diseases. 2. Gastroscopy is more commonly carried out by physicians, coloscopy by gastroenterologists or specialists. Hospital doctors don't contribute significantly to ambulant endoscopic examinations of stomach and colon. 3. Endoscopic examinations of the pancreas, biliary tree, laparoscopy and other techniques play an insignificant role in ambulant practice. 4. The complication rate of ambulant gastroenterological endoscopy is very low. There have been only a few malpractice cases due to complications of gastroenterological endoscopic examinations. 5. The quality of coloscopy is not yet satisfactory as measured by the relative proportions of partial and total coloscopy. 6. In the past only limited attention was given to aspects of quality assurance and quality control in endoscopy in ambulant practice. This should be changed in the future. 7. The fees for gastroscopy and coloscopy allowed by the public insurance companies don't cover the expenses and are inadequate. As a result, a negative impact on the quality of medical care can be expected.