CMS colonoscopy quality measure may be inaccurate, study says

Patients who received an outpatient colonoscopy seldom go to the emergency rooms for unplanned complications, and of those who do it's often for reasons unrelated to the procedure, according to a study published in Clinical and Experimental Gastroenterology.

Researchers conducted a retrospective single-center observational study from July 2018 to December 2019 reviewing 5,344 outpatient colonoscopies.

Researchers found 1.05 percent or 56 patients had a post-colonoscopy ER visit. Thirty-two percent of total patients reported gastrointestinal symptoms like abdominal pain or GI bleeding. Patients who had GI symptoms had a higher rate of polypectomies performed and were more likely to use illicit drugs. About 41 percent of patients who went to the ER went for reasons unrelated to colonoscopy.

Researchers performed the study in response to CMS' decision to publicly report the quality of outpatient endoscopy facilities by using risk-standardized rates of unplanned hospital visits within seven days of a colonoscopy.

Researchers concluded: "Our study highlights that unplanned visits within seven days of colonoscopy are not necessarily related to the procedure, and those that are, tend to be due to unavoidable patient factors. Hence the CMS measure may not be an accurate determinant of the quality of procedure or facility care delivered."

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