The frequency of early repeat tests after colonoscopy in elderly medicare recipients

Robert J. Richards, Stephen Crystal

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background The frequency of early repeat and follow-up tests (RAFTs) occurring after colonoscopy has not been previously examined in the literature. RAFTs incur cost, discomfort, and inconvenience to patients who have undergone colonoscopic examination; therefore, it is important to identify factors associated with their use. Methods We identified elderly Medicare recipients who had colonoscopy performed in 1999 from the 5% Medicare administrative files (N = 69,282). We determined the number of early RAFTs (repeat colonoscopy, barium enema, flexible sigmoidoscopy) occurring within the year of initial colonoscopy. Results Of the study sample, 8.3% required at least one RAFT during the year. Using multivariable analysis, we found that RAFTs varied significantly with age, race, sex, income, comorbidity, provider type, and place of service. RAFTs were 22% higher in African Americans compared to whites. Gastroenterologists used 20-35% fewer RAFTs than the other provider types performing colonoscopy. Conclusions The frequency of early RAFTs after colonoscopy occurs in 8.3% of the Medicare population. Important differences exist in the frequency of RAFTs by race and provider type.

Original languageEnglish (US)
Pages (from-to)421-431
Number of pages11
JournalDigestive diseases and sciences
Volume55
Issue number2
DOIs
StatePublished - Feb 1 2010

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Colonoscopy
Medicare
Sigmoidoscopy
African Americans
Comorbidity
Costs and Cost Analysis
Population

All Science Journal Classification (ASJC) codes

  • Physiology
  • Gastroenterology

Keywords

  • Colon cancer
  • Colonoscopy
  • Disparities
  • Quality
  • Race
  • Screening

Cite this

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abstract = "Background The frequency of early repeat and follow-up tests (RAFTs) occurring after colonoscopy has not been previously examined in the literature. RAFTs incur cost, discomfort, and inconvenience to patients who have undergone colonoscopic examination; therefore, it is important to identify factors associated with their use. Methods We identified elderly Medicare recipients who had colonoscopy performed in 1999 from the 5{\%} Medicare administrative files (N = 69,282). We determined the number of early RAFTs (repeat colonoscopy, barium enema, flexible sigmoidoscopy) occurring within the year of initial colonoscopy. Results Of the study sample, 8.3{\%} required at least one RAFT during the year. Using multivariable analysis, we found that RAFTs varied significantly with age, race, sex, income, comorbidity, provider type, and place of service. RAFTs were 22{\%} higher in African Americans compared to whites. Gastroenterologists used 20-35{\%} fewer RAFTs than the other provider types performing colonoscopy. Conclusions The frequency of early RAFTs after colonoscopy occurs in 8.3{\%} of the Medicare population. Important differences exist in the frequency of RAFTs by race and provider type.",
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The frequency of early repeat tests after colonoscopy in elderly medicare recipients. / Richards, Robert J.; Crystal, Stephen.

In: Digestive diseases and sciences, Vol. 55, No. 2, 01.02.2010, p. 421-431.

Research output: Contribution to journalArticle

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