Evolution of the two-week rule pathway--direct access colonoscopy vs outpatient appointments: one year's experience and patient satisfaction survey.

摘要: Objectives  The aim of this study was to compare the effectiveness Direct access colonoscopy (DAC) vs outpatient appointments for two-week rule colorectal cancer referrals and evaluate satisfaction patients referred through these routes. Patients methods  Data were collected prospectively from January 2003 December on who DAC or at discretion referring General practitioner via Lower GI pathway. A postal questionnaire used survey patient satisfaction. Results  Six hundred thirty-nine pathway; 188 underwent their initial hospital visit 19 (10.1%) cancers diagnosed; 442 had an appointment 32 (7.2%) identified. There 7 (1%) inappropriate 2 refused investigations. All outcome parameters measured reduced directly including time definitive investigations (Median 9 52 days P < 0.0001), histological diagnosis 14 42 days P < 0.0001) treatment 55 75 days P < 0.0483). One seventy surveyed by whom 127 (75%) responded. Ninety-eight percent satisfied with service provided. Four (6.6%) 60 undergone direct expressed a desire be seen department initially. Conclusions  results in significantly times cancer. Patients can admitted bypassing clinic without affecting satisfaction.