‘AAA’-rated colonoscopy providers would improve NBCSP referrals

Associate Professor Peter Bampton

Private colonoscopy providers could offer a fast and affordable referral pathway as an alternative to public hospitals struggling to achieve timely colonoscopy for patients referred from the National Bowel Cancer Screening Program, Adelaide gastroenterologists say.

Giving patients, GPs and government  clear information on the 3 A’s of colonoscopy clinics’ Affordability, Availability and Ability would allow more informed choices about whether to have colonoscopy done in the public or private system, write clinicians in a letter in the MJA.

The authors, led by Associate Professor Peter Bampton, say they tested the concept of a discounted private anaesthetist-assisted colonoscopy service by offering 100 high-risk patients colonoscopy for an out-of-pocket fee of $310.

This resulted in seven cancers being diagnosed and the clinicians had an adenoma detection rate of 66%. Furthermore, the private colonoscopy services resulted in savings of around $95,000 in total treatment costs for the 100 patients. This was based on an estimate of $190,000 it would have cost to the state budget to provide them in the public system at $1900 per colonoscopy.

The results show that private colonoscopy providers can offer affordable and quality services that will help improve the efficiency of the NBCSP, the authors conclude.

However, they acknowledge that in the real world out-of-pocket costs may vary markedly between providers, and patients and GPs can’t always obtain this information before referral.

“A patient needing a colonoscopy could get it done for free in a public hospital, but sometimes not in a timely manner, which we consider to be within 120 days of referral,” said co-author Dr Dan Worthley, Cancer Research Fellow at the South Australia Health and Medical Research Institute (SAHMRI)

“Alternatively, the private system is typically efficient timewise, but the cost can vary widely and be hard to comprehend because of multiple separate fees.”

These problems and other barriers could be addressed if all colonoscopy providers supplied up to date information on the 3 A’s, the study authors suggest.

“Private and public services should provide current information to GPs, patients and government concerning their affordability (total out-of-pocket fee), ability ( and availability (waiting time from GP referral to colonoscopy)”.

“This would help optimise the benefits of the National Bowel Cancer Screening Program and allow the public and private sectors to work together to eradicate bowel cancer death in Australia,” they write.

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