Endoscopy COVID-19 testing requirements disproportionately impact medically underserved communities

Published in Gastroenterology, a commentary by University of Minnesota Medical School researchers found that medically underserved people (Black, American Indian/Alaska Native or Hispanic) are three times more likely to cancel their endoscopy related to issues with COVID-19 testing requirements.

"While well-intentioned, additional requirements for care often create barriers that are not equal across race," said Elizabeth Aby, a University of Minnesota Medical School fellow.

The research team examined all consecutive canceled outpatient endoscopic procedures between March 1 and September 7, 2021, at the University of Minnesota Medical Center.

While the cancelation reasons for endoscopy are documented routinely, additional information on the specific barriers that led to the disparity were not available. Researchers believe multiple factors likely contributed including patient-, provider- and system-level factors. These barriers can lead to delays in diagnosis and management of gastrointestinal illnesses. It also has the potential to lead to higher rates of cancer-related morbidity and death.

The research team concluded that health care systems should consider how additional testing requirements specifically impact medically underserved communities. They also say it's important to recognize that pre-procedure testing may introduce an additional barrier to care and has the potential to introduce or widen existing disparities. If a health system chooses to continue COVID-19 testing, researchers suggest mailing test kits to patients several weeks before the procedure or offering rapid testing.