Electronic Tracking Ups Capture of Endoscopy Complications

Complications requiring hospital visit found to be higher than standard reporting estimates
By Lindsey Marcellin
HealthDay Reporter

WEDNESDAY, Oct. 27 (HealthDay News) -- An electronic tracking system picks up more outpatient endoscopic-related complications requiring an emergency department visit/hospitalization than does standard physician reporting, according to research published in the Oct. 25 issue of the Archives of Internal Medicine. These visits add substantially to the real cost of endoscopic procedures.

Daniel A. Leffler, M.D., of the Beth Israel Deaconess Medical Center in Boston, and colleagues followed up on 6,383 patients having esophagogastroduodenoscopies (EGDs) and 11,632 patients having colonoscopies using an electronic medical record-based system to automatically record admissions to the emergency department within 14 days after these endoscopic procedures. The incidence of complications using this method was compared to the incidence captured by standard physician reporting.

The researchers found that complications requiring a hospital visit occurred in 1.07, 0.84, and 0.95 percent of EGDs, colonoscopies, and screening colonoscopies, respectively, during the 14 days post-procedure -- percentages that were two- to three-fold higher than recent complication estimates based on standard reporting. Mean costs were $1,403 per emergency department visit and $10,123 per hospitalization; overall these visits added $48 to the cost of each colonoscopy.

"In summary, we report the use of a novel electronic medical record-based adverse event tracking system that allows for more accurate assessment of complications and permits real-time monitoring of adverse event rates. We found that this system significantly expanded adverse event detection rate compared with traditional voluntary reporting and suggests an unexpectedly high financial burden of these events," the authors write.

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