Projected increased growth rate of anesthesia professional-delivered sedation for colonoscopy and EGD in the United States: 2009 to 2015

Background: Anesthesia professional delivered sedation has become increasingly common when performing colonoscopy and EGD. Objective: To provide an estimate of anesthesia professional participation rates in colonoscopy and EGD procedures and to examine rate changes over time and geographic variations for both procedures. Design: Retrospective sample design. Setting: National survey data from i3 Innovus for the period 2003 to 2007 on the use rate of anesthesia professionals in both procedures. Patients: A sample of 3688 observations included 3-digit zip code-level information on anesthesia professional use rates. Interventions: Data were linked to the Bureau of Health Professions' Area Resource File to control for sociodemographic factors and provider supply characteristics for anesthesia professional use rates. Main Outcome Measurements: Multivariable regression analyses were performed to identify factors predicting the use rate of anesthesia professionals in these procedures and to forecast use rates for the years 2009 to 2015. Results: For colonoscopy and EGD, anesthesia professional participation is projected to grow from 23.9% and 24.4% in 2007 to 53.4% and 52.9% by 2015, respectively. Average growth rates were highest in the northeast for colonoscopy (145.8%) and EGD (146.6%). Anesthesia professional use rates were significantly greater in areas having a higher percentage of older subjects (45 years and older), higher per capita income and lower unemployment rates, and higher per capita inpatient admissions and were significantly lower in areas having more per capita outpatient visits for both procedures. Limitations: Nonexperimental retrospective sample study design. Database sample May not be nationally representative. Market area characteristics were used to control for socioeconomic and demographic factors. However, there may remain some important market factors that we were unable to control. Conclusions: Anesthesia professional delivered sedation is projected to grow substantially for both procedures. (Gastrointest Enclose 2010;72:580-6.)