Direct access endoscopy in a Brazilian public healthcare facility: comparable results with specialist referred endoscopy

Abstract

Background

Direct access endoscopy (DAE) is the procedure performed without the pre-evaluation of the patient by a specialist. It is widely available in many medical services around the world, but there is lack of data about this strategy in the setting of the public health system in Brazil. Therefore, the aim of this study is to compare the main endoscopic findings of upper gastrointestinal endoscopy requested through DAE and by specialists.

Methods

Longitudinal, retrospective single center study in patients who underwent upper digestive endoscopy in a public healthcare facility at the southern region of the state of Mato Grosso, Brazil, from August 2011 to December 2018. Age, gender, modality of endoscopy request (DAE or endoscopy requested by specialists), and endoscopic findings were analyzed.

Results

A total of 2810 patients were included. Most of them were female 65.23% (1833), mean age was 47.36 years, and 50.71% of the exams (1425) were DAE. Only 4.62% of the exams had normal reports. The most frequent endoscopic findings were gastritis (91.99%), bulboduodenitis (43.59%) and reflux esophagitis (14.76%). Patients who underwent endoscopy requested by specialists were older (50.25 ± 16.57 vs. 44.55 ± 16.31 years, p < .0001) and more frequently men (36.61 vs. 32.98%, p = .0437) in comparison to DAE. However, endoscopic findings were similar in both groups.

Conclusion

This study shows that direct access upper endoscopy had comparable results to specialist requested endoscopy in a public healthcare facility in the southern region of the state of Mato Grosso, Brazil.

Keywords:

• Direct access endoscopy
• endoscopy
• diagnosis
• gastritis
• public healthcare

Ethical approval

The Ethics Committees of the University of Campinas (UNICAMP) approved this study (number 3.266.033). The protocol followed the 1975 Declaration of Helsinki. Informed consent was waived.

Author contributions

de Oliveira FAB performed the upper endoscopy exams, collected and assembled the data, contributed to the data analysis and interpretation. Mazo DF conceived and designed the study, contributed to the data analysis and interpretation and wrote the manuscript. All authors read and approved the final version of the manuscript.

Disclosure statement

The authors report no conflicts of interest in this work.