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Volume 6, Issue 6(Suppl) J Gastrointest Dig Syst
ISSN:2161-069X JGDS, an open access journal
Page 20
Clinical Gastroenterology 2016
October 03-05, 2016
conferenceseries.com
October 03-05, 2016 Toronto, Canada
8th International Conference on
Clinical Gastroenterology & Hepatology
Indran Indrakrishnan, J Gastrointest Dig Syst 2016, 6:6(Suppl)
Identification and correction of decreasing cancer screening colonoscopy rate during the economic
recession
Colon cancer is a silent killer and is the second common cause of cancer deaths in the country. This very same colon cancer
is one of the most easily curable cancers if detected early and it is preventable by removal of precancerous polyps by the
screening colonoscopy. This colon cancer screening colonoscopy is highly recommended by multiple governmental agencies
and professional societies for people at or over 50 years and others who are at higher risk even before they reach 50. The rate
of this life saving screening colonoscopy has decreased re-entry mainly due to no shows and cancellations at our center. This is
presumably due to various impacts from economic recession which include but not limited to loss of jobs, high deductible/high
copayments from the insurance companies. When faced with economic insecurity, asymptomatic individuals may be unable to
afford screening colonoscopy, or may perceive it to be less important than competing demands for their more limited resources.
Reduced screening rates during the recession may ultimately increase health care costs and result in cancer related deaths. This
is consistent with literature in other fields of medicine. For instance, during difficult economic times women are more likely to
be diagnosed with advanced rather than local breast cancer. The purpose of this study is to identify the incidence and causes of
no shows and cancellations for the screening colonoscopies at our center. Once done, then apply corrective measures if any and
thereby reduce the no shows and cancellations, and increase the screening colonoscopy rate. This is important for good quality
patient care. First, we analyzed the data of the previous years before the economic recession and compared with the present
one. Total number of screening colonoscopies scheduled: 443; total cancellation: 35 (7.9%); commercial insurance screening
colonoscopies (CISC) scheduled: 312; CISC cancellation: 25 (8%); total cancellation/no shows rate decreased from 13.8% in
the initial measurement to 7.9% in the re-measurement group. CISC cancellation rate was 19.9% in the initial measurement
and 8% in the re-measurement group. This is a statistically significant decrease with a P value <0.001. The re-measurement
values are not identical to the performance goal but are closer. The above data was derived from the patients’ encounters
where they cancelled the procedures with the endoscopy center. There may be a very large number of patients who declined
the screening colonoscopies at the entry level at the primary care physicians’ offices due to the unawareness of the screening
benefits. We recommend that the primary care physician’s offices to specifically emphasize and advice to the patients that their
cancer screening colonoscopies are completely covered under preventive care regardless high deductible and co-pays and
advise accordingly at the time of referrals especially when the insurance coverage is complete. The high deductible/high co pay
insurance has become rampant under the present economy with employers and insurance companies finding the ways to cut
their cost. Advising the patients proactively about the insurance implications in preventive healthcare tests is a commendable
practice in continuing to provide a good preventive healthcare to the community. This recommendation is applicable to other
preventive screening tests such as Mammograms, PAP smears, PSA and bone density tests.
Biography
Indran Indrakrishnan is a Clinical Professor of Medicine at the Emory University School of Medicine and the Medical Director of GDC Endoscopy Center LLC &
Gwinnett Digestive Clinic PC in Atlanta GA. He was the Former President and currently on the Board of Directors of Georgia Gastroenterological and Endoscopic
Society. He has served and has been serving on numerous committees including American College of Gastroenterology, American College of Physicians, Medical
Association of Georgia and AAAHc International. He has organized and spoken at many CME conferences across the country and has won many distinguished
awards from national and international scientific organizations. He has published several Clinical and Basic Science research articles and is in the Editorial Boards
of peer review journals. He has a special interest in the Management and Public Education of Colorectal Cancer and is on the Board of Directors of Fight Colorectal
Cancer, a national nonprofit patient advocacy organization.
Indran Indrakrishnan
GDC Endoscopy Center, USA