Observational studyCanadian family physician Medecin de famille canadien
Management of nonurgent common gastroenterology referrals using primary care clinical pathways: Clinical outcomes, health care use, and avoided costs.
Observational study in Canadian family physician Medecin de famille canadien. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Reduced wait times for hepatology referrals in a prospective quality improvement initiative.Hepatology communications · 2026Article
- Age- and Risk-Based Stratification in Dyspepsia: Redefining Endoscopic Thresholds for Clinically Significant and Malignant Findings.Clinics and practice · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate health system use, health outcomes, and avoided costs when patients with chronic gastrointestinal (GI) conditions are managed in the medical home.
designA retrospective, observational cohort study was conducted through a single-point-of-entry referral system.
settingCalgary, Alta.
participantsPatients with referrals for any of 7 nonurgent indications.
main outcome measuresPatients with referrals for any of 7 nonurgent indications were returned to primary care for management, guided by evidence-based primary care pathways. Patients were linked to administrative databases to extract indications, re-referral rates, endoscopy findings and outcomes, number of emergency department and urgent care visits, and number of hospital admissions. Costs avoided were estimated using Canadian Institute for Health Information data for health care use, consultation, and endoscopy.
resultsBetween July 1, 2018, and May 31, 2020, a total of 3435 routine referrals were closed for 3274 patients. The most common pathway used was dyspepsia (1154 of 3435, 33.6%). A total of 362 patients (11.1%) had 616 GI-related emergency department or urgent care visits; 52 (1.6%) patients experienced 68 GI-related hospitalizations. A total of 396 patients (12.1%) underwent endoscopy; of the 348 patients with findings available for analysis, 7.8% exhibited a clinically significant finding. The estimated total cost avoided was $1,477,237.
conclusionThe implementation of co-developed primary care pathways safely supports the care of patients with common, nonurgent GI conditions within the medical home. In this population, rates of re-referral and health care use were low, resulting in avoidance of substantial costs and improved overall appropriateness of care.
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