The Problem of the Inappropriate Endoscopy
Authors: John F. Morrissey
Journal: Annals of Internal Medicine (1988)

Editorials15 October 1988The Problem of the Inappropriate EndoscopyJohn F. Morrissey, MDJohn F. Morrissey, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-8-605 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe rapid escalation of the cost of medical care in the face of limited resources has led insurance carriers, including Medicare, to look hard at high-cost medical procedures such as gastrointestinal endoscopy. Medicare intermediaries have been encouraged to deny payment to physicians for nonindicated procedures. The data available from the medical literature are of limited help in evaluating the appropriateness of procedures. Controlled trials have not been done for most indications. The guidelines of the American Society for Gastrointestinal Endoscopy (1) are excellent, but in each guideline, there is a caution that under exceptional circumstances, procedures may be considered appropriate,...References1. Statements and guidelines developed by the Standards of Training and Practice Committee of the ASGE. Gastrointest Endosc. 1988;34(3 Suppl):1S-40S. MedlineGoogle Scholar2. KahnParkBrook KRR The effect of comorbidity on appropriateness ratings for two gastrointestinal procedures. J Clin Epidemiol. 1988;41:115-22. CrossrefMedlineGoogle Scholar3. KahnKosecoffChassinSolomonBrook KJMDR. The use and misuse of upper gastrointestinal endoscopy. Ann Intern Med. 1988;109:664-670. LinkGoogle Scholar4. KahnFink KA. Diagnostic upper gastrointestinal endoscopy: a literature review and ratings of appropriateness. Santa Monica: Rand; 1986. Google Scholar5. CameronOttPayne ABW. The incidence of adenocarcinoma in columnar-lined (Barrett's) esophagus. N Engl J Med. 1985;313:857-9. CrossrefMedlineGoogle Scholar6. SpechlerRobbinsRubins SAH Adenocarcinoma and Barrett's esophagus: an overrated risk? Gastroenterology. 1984;87:927-33. CrossrefMedlineGoogle Scholar7. ChassinKosecoffPark MJR Does inappropriate use explain geographic variations in the use of health services? A study of three procedures. JAMA. 1987;258:2533-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Wisconsin Medical School Madison, Wisconsin Nextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByAccuracy of provisional diagnoses of dyspepsia in patients undergoing first endoscopyOveruse and underuse of colonoscopy in a European primary care settingQuality and Outcome Determination in Health Care and Orthopaedics: Evolution and Current StructurePerformance of panel-based criteria to evaluate the appropriateness of colonoscopy: a prospective studyOveruse of upper gastrointestinal endoscopy in a country with open-access endoscopy: a prospective study in primary careAppropriateness of indications for diagnostic upper gastrointestinal endoscopy: Association with relevant endoscopic diseaseImpact of a quality assurance program on gastrointestinal endoscopyGastrointestinal EndoscopyUse of Endoscopy in Peptic Ulcer DiseaseA Managed Care Approach to Outpatient ReviewUpper Gastrointestinal EndoscopyRonald E. Feldman, MD 15 October 1988Volume 109, Issue 8Page: 605-606KeywordsEndoscopyMedicare Issue Published: 15 October 1988 PDF DownloadLoading ...