Gastroenterology service in a teaching hospital in rural New Zealand, 1991-2003

Table 1 Patient numbers and demographics

	Yr
	1991	1997	2003
Inpatients
No. of admissions1	173	310	391
Rate per 10 000 population2	9	16	20
Age mean (SD)3	54.1 (19.7)	55.9 (18.9)	53.4 (19.1)
Female n (%)	97 (56)	196 (63)	210 (54)
Outpatients
No. of admissions1	553	469	756
Rate per 10 000 population2	30	25	39
No. of patients with information available	399	404	716
Age mean (SD)3	49.0 (19.3)	47.0 (18.0)	50.1 (18.5)
Female n (%)	246 (62)	256 (63)	421 (59)

¹First hospital admissions and first specialist consultations showed a statistically significant linear increase over the years (P < 0.001 for both);

²Estimates of the Otago population obtained from the Ministry of Social Development website: http://www.socialreport.msd.govt.nz/regional/r-councils/otago.html;

³There was a statistically significant difference in the mean age of inpatients and outpatients (P < 0.001).

Table 2 Number (percentage) of diagnoses seen in the inpatient and outpatient setting¹

Diagnosis	1991	1997	2003	Total
Inpatient
Liver disease (including Hepatitis)and Abnormal LFTs4	33 (15.1)	90 (20.3)	124 (23.5)	247 (20.8)
Biliary disease	22 (10.1)	91 (20.5)	78 (14.8)	191 (16.1)
Inflammatory bowel disease3	38 (17.4)	47 (10.6)	54 (10.2)	139 (11.7)
Malignancy	23 (10.6)	34 (7.7)	47 (8.9)	104 (8.7)
Other diseases of colon/anus/rectum3	13 (6.0)	30 (6.8)	17 (3.2)	60 (5.0)
Abdominal pain unknown cause	12 (5.5)	9 (2.0)	35 (6.6)	56 (4.7)
Iron studies related disorders3	14 (6.4)	18 (4.1)	7 (1.3)	39 (3.3)
Constipation4	4 (1.8)	5 (1.1)	29 (5.5)	38 (3.2)
Pancreatic disease	7 (3.2)	11 (2.5)	17 (3.2)	35 (2.9)
Infective	5 (2.3)	14 (3.2)	8 (1.5)	27 (2.3)
Oesophagitis/GORD	4 (1.8)	9 (2.0)	8 (1.5)	21 (1.8)
Peptic ulcer disease	0 (0)	4 (0.9)	10 (1.9)	14 (1.2)
Irritable bowel syndrome	3 (1.4)	2 (0.5)	1 (0.2)	6 (0.5)
Haemorrhoids	0 (0)	1 (0.2)	1 (0.2)	2 (0.2)
Other functional disease	0 (0)	1 (0.2)	0 (0)	1 (0.1)
Other gastroenterological diagnosis2	31 (14.2)	67 (15.1)	82 (15.6)	180 (15.1)
Non-Gastroenterological diagnosis	9 (4.1)	11 (2.5)	9 (1.7)	29 (2.4)
Total	218 (100)	444 (100)	527 (100)	1189 (100)
Outpatient
Liver disease (including Hepatitis) and Abnormal LFTs4	29 (6.4)	61 (13.5)	108 (12.9)	198 (11.4)
Other functional disease3	70 (15.5)	60 (13.3)	63 (7.6)	193 (11.1)
Abdominal pain unknown cause3	82 (18.2)	36 (8.0)	55 (6.6)	173 (10.0)
Constipation4	23 (5.1)	26 (5.8)	78 (9.4)	127 (7.3)
Oesophagitis/GORD	27 (6.0)	22 (4.9)	64 (7.7)	113 (6.5)
Irritable bowel syndrome	26 (5.8)	24 (5.3)	60 (7.2)	110 (6.3)
Family history of bowel cancer4	13 (2.9)	25 (5.5)	70 (8.4)	108 (6.2)
Other diseases of colon/rectum/anus	23 (5.1)	39 (8.6)	46 (5.5)	108 (6.2)
Inflammatory bowel disease	19 (4.2)	23 (5.1)	47 (5.6)	89 (5.1)
Haemorrhoids	16 (3.5)	15 (3.3)	47 (5.6)	78 (4.5)
Iron studies related disorders4	10 (2.2)	4 (0.9)	41 (4.9)	55 (3.2)
Infective (excluding Hepatitis)	8 (1.8)	26 (5.8)	10 (1.2)	44 (2.5)
Biliary disease	8 (1.8)	12 (2.7)	14 (1.7)	34 (2.0)
Malignancy	4 (0.9)	3 (0.7)	12 (1.4)	19 (1.1)
Peptic ulcer disease	9 (2.0)	1 (0.2)	8 (1.0)	18 (1.0)
Pancreatic disease	2 (0.4)	4 (0.9)	7 (0.8)	13 (0.8)
Other gastroenterological diagnosis2	73 (16.2)	52 (11.5)	78 (9.4)	203 (11.7)
Non-Gastroenterological diagnosis	9 (2.0)	18 (4.0)	26 (3.1)	53 (3.0)
Total	451 (100)	451 (100)	834 (100)	1736 (100)

¹Number of diagnoses adds to more than the number of inpatients as a patient could have more than one diagnosis. The top 5 diagnostic categories per year and overall are highlighted;

²This is a grouping of all the other minor diagnostic categories seen;

³A statistically significant linear decrease over the years [Inpatient: Inflammatory bowel disease, other diseases of colon/anus/rectum and iron studies related disorders (P = 0.015, 0.040 and < 0.001, respectively); Outpatient: Abdominal pain of unknown cause and other functional disease (P < 0.001 for both)];

⁴A statistically significant linear increase over the years [Inpatient: Liver disease and constipation (P = 0.010 and 0.001, respectively); Outpatient: Liver disease, family history of bowel cancer, constipation and iron studies related disorders (P = 0.001, < 0.001, 0.003 and 0.002, respectively)].

Table 3 Procedure numbers and patient demographics

	Yr
	1991	1997	2003
Colonoscopy
No. of procedures	638	580	692
Rate per 10 000 population1	34	31	36
Age mean (SD)	57.3 (14.5)	58.2 (15.0)	59.4 (14.7)
Female n (%)2	319/632 (50)	295/537 (55)	349/692 (50)
Gastroscopy
No. of procedures	1439	1812	1544
Rate per 10 000 population1	77	96	80
Age mean (SD)	58.9 (17.9)	58.1 (17.5)	58.4 (18.6)
Female n (%)2	726/1432 (51)	824/1595 (52)	793/1540 (51)

¹Estimates of the Otago population obtained from the Ministry of Social Development website: http://www.socialreport.msd.govt.nz/regional/r-councils/otago.html;

²Denominator given as data on sex was not available for all patients.