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News

Disparities in evaluation of patients with rectal bleeding  

A study in the most recent issue of Clinical Gastroenterology & Hepatology reports disparities in evaluation of patients with rectal bleeding 40 years and older. 

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Rectal bleeding is associated with colorectal cancer.

Dr Helen Shields and colleagues characterized the evaluation of patients aged 40 years and older with rectal bleeding and identified characteristics associated with inadequate evaluation.

The research team conducted a retrospective review of records of outpatient visits that contained reports of rectal bleeding for patients aged 40 years and older.

The researchers studied whether patient characteristics affected whether or not they received a colonoscopy examination within 90 days of presentation with rectal bleeding.

Patient characteristics included demographics, family history of colon cancer and polyps, and histories of screening colonoscopies, physical examinations, referrals to specialists at the index visit, and communication of laboratory results.

Data were collected from medical records, and patient income levels were estimated based on Zip codes.

A family history was more likely to be documented among patients with private insurance
Clinical Gastroenterology & Hepatology

The research team found that 48% of the patients presenting with rectal bleeding received colonoscopies, and 82% received the procedure within 90 days.

A history of a colonoscopy examination was more likely to be reported in white patients compared with Hispanic or Asian patients, and in high-income compared with low-income patients.

The researchers noted that a family history was more likely to be documented among patients with private insurance than those with Medicaid or Medicare.

A rectal examination was performed more often for patients who were white or Asian, male, and with high or middle incomes, compared with those who were black, Hispanic, female, or with low incomes.

The research team observed that white patients were more likely to have their laboratory results communicated to them than black patients.

Dr Shields and team comments, "Sex, race, ethnicity, patient income, and insurance status were associated with disparities in evaluation of rectal bleeding."

"There is a need to standardize the evaluation of patients with rectal bleeding."

Clin Gastroenterol Hepatol 2014: 12(4): 669-675
26 March 2014

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