Geographic variation in the provider of screening colonoscopy in Canada: a population-based cohort study.

Geographic variation in the provider of screening colonoscopy in Canada: a population-based cohort study. CMAJ Open. 2018 Mar 13;6(1):E126-E131 Authors: Doumouras AG, Anvari S, Cadeddu M, Anvari M, Hong D Abstract BACKGROUND: Screening colonoscopy for the detection of colorectal carcinoma is provided by several specialties. Few studies have assessed geographic variation in the delivery of this care. Our objective was to investigate how geographic and socioeconomic factors affect who provides screening colonoscopy in Canada. METHODS: This was a population-based cohort of all screening colonoscopy procedures performed at publicly funded Canadian health care facilities (excluding those in Quebec) between April 2008 and March 2015. The main outcome of interest was the proportion of colonoscopy procedures performed by surgeons versus gastroenterologists at the neighbourhood level. Predictors of interest included socioeconomic and geographic variables. We used spatial analysis to evaluate significant clustering of practitioner services and multinomial logistic regression to model predictors. RESULTS: We identified 658 113 screening colonoscopy procedures performed by 1886 providers (1169 surgeons and 717 gastroenterologists) over the study period, of which 353 165 (53.7%) were performed by surgeons. A total of 24.2% of neighbourhoods were located within clusters predominantly served by gastroenterologists, and 19.5% wer...
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Open Source Type: research