Original article—alimentary tractColonoscopy Completion in a Large Safety Net Health Care System
Section snippets
Study Setting and Population
The study was carried out at Denver Health Medical Center (DHMC), a large community-based medical facility that serves more than 25% of Denver County residents. Fourteen percent of DHMC patients are black, and 54% are Latino. Approximately 65% of patients are below 185% of the federal poverty level, and uninsured patients account for 42% of all charges. DHMC also provides services for incarcerated patients in the City and County of Denver.
Screening and surveillance colonoscopies at DHMC are
Results
The final sample included 817 patients scheduled for outpatient colonoscopy. The overall nonattendance rate was 41.7% (Table 1). Less than 5% cancelled their procedures with less than 48 working hours notice; the vast majority simply did not arrive for the exam. Contrary to previously published observations, female sex, younger age, black and Latino race/ethnicity, and procedure indication were not associated with higher rates of nonattendance. However, attendance was significantly higher than
Discussion
Colonoscopy nonattendance was extremely high in almost all patient groups within a large safety net system. In addition, although 30.2% of patients who attended their appointments had an inadequate bowel preparation, consistent with a rate quoted in a recent meta-analysis of non–safety net systems,13 the rate of poor (as opposed to fair) quality preparation was 9.9%, which guarantees that at least 1 in 10 patients could not complete any meaningful portion of an exam. Thus, when poor bowel
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Supported in part by the American Cancer Society MRSG-06-081-01-CPPB, principal investigator, Dr Denberg.