Brief Articles
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Feb 7, 2009; 15(5): 583-590
Published online Feb 7, 2009. doi: 10.3748/wjg.15.583
Gastroenterology service in a teaching hospital in rural New Zealand, 1991-2003
Michael Schultz, Andrew Davidson, Sarah Donald, Bogna Targonska, Angus Turnbull, Susan Weggery, Vicki Livingstone, John D Dockerty
Michael Schultz, Department of Medical and Surgical Sciences, University of Otago, PO Box 913, Dunedin, New Zealand and Department of Gastroenterology, Dunedin Public Hospital, Otago District Health Board, Dunedin, New Zealand
Andrew Davidson, Sarah Donald, Bogna Targonska, Angus Turnbull, Susan Weggery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
Vicki Livingstone, John D Dockerty, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
Author contributions: Schultz M and Dockerty JD designed and supervised the research; Davidson A, Donald S, Targonska B, Turnbull A, Weggery S performed the work and wrote the paper; Livingstone V supervised and consulted the statistical methods.
Correspondence to: Dr. Michael Schultz, MD, FRACP, Dr. habil. (Germany), Department of Medical and Surgical Sciences, University of Otago, PO Box 913, Dunedin, New Zealand. michael.schultz@otago.ac.nz
Telephone: +64-3-4740999
Fax: +64-3-4747724
Received: September 28, 2008
Revised: November 18, 2008
Accepted: November 25, 2008
Published online: February 7, 2009
Abstract

AIM: To retrospectively collect inpatient and outpatient data and to assess the use of endoscopic procedures during the years 1991, 1997 and 2003 to analyse for trends.

METHODS: This retrospective survey was conducted in a University-associated Gastroenterology Unit offering secondary and tertiary health care services for a population of approximately 182 000 people in Southern New Zealand. Data collected included patient contacts (in- and outpatients), gastroscopic and colonoscopic investigations.

RESULTS: We observed a significant increase in the absolute numbers of patient contacts over the years (1991: 2308 vs 1997: 2022 vs 2003: 2783, P < 0.0001) with inflammatory bowel disease, other diseases of the colon, anus and rectum and iron studies related disorders decreasing significantly but liver disease and constipation increasing linearly over time. The use of endoscopy services remained relatively stable but colonoscopic investigations for a positive family history of colorectal cancer increased significantly while more gastroscopies were performed for unexplained anaemia.

CONCLUSION: The whole spectrum of gastroenterology contacts was studied. A substantial proportion of colonoscopies and outpatient consultations were undertaken to screen for colorectal cancer. This proportion is likely to grow further. Our findings have implications for the recruitment and training of the next generation of gastroenterologists.

Keywords: Colonoscopy, Colorectal cancer, Disease trends, Endoscopy, Gastroenterology, Hepatitis, Inflammatory bowel disease, Recruitment, Workforce