A survey on percutaneous endoscopically placed gastrostomy in the northwest: Influence of work setting

OBJECTIVE: A survey was undertaken to determine the influence of practice s etting on the way Pacific Northwest gastroenterologists per-form and manage percutaneous endoscopically placed gastrostomy (PEG). METHODS: A 12-question survey was distributed to 196 members of the Pacific Northwest Gastroenterology Society (PNWGS) regarding their specifics of pl acing and managing PEG. The responses were compared according to work setti ng, i.e., private practice, armed services, staff model HMO's, and universi ty affiliated hospitals. The data were analyzed using the chi (2) test. RESULTS: Sixty-nine of 126 practicing gastroenterologists responded, 75% we re in private practice (PP) and 25% in the combined other work settings (no n-PP). The mean number of PEG placed by all groups was 23. Seventy-three pe rcent of PP performed PEG without a second physician. Antibiotics were used prophylactically in both PP and non-PP by 96%. There was no difference bet ween groups in use of standardized forms or in time before instituting feed ings. The non-PP groups used preprocedure labs (p = 0.037) and loosening sk in surface bumpers (p = 0.035) more frequently. The uniform impression was that PEG was associated with the same or fewer complications currently than in the past. CONCLUSIONS: In the PP setting, gastroenterologists tend to place PEGS with out a second physician and use standardized forms and bumper loosening less frequently than non-PP gastroenterologists. These variations reflect that teaching institutions as well as staff model HMOs make access to an assista nt easier. Respondents expressed confusions on billing for PEG. They percei ved the procedure to be as safe or safer than in the past. The PEG has evol ved into a frequently performed procedure whose practice variations are out growths of one's work environment as well as one's training. (C) 2001 by Am . Coll. of Gastroenterology.