S0541 Patients Infrequently Consent to Endoscopy Upon Practice Re-Opening During the COVID Pandemic

INTRODUCTION: The COVID pandemic prompted increased use of telemedicine and discontinuation of elective endoscopic procedures Resumption of elective endoscopy is based upon juris-dictional guidelines, health care resources and the ability to provide a safe environment for staff and patients Implementation of safety measures markedly reduces COVID risk However, the impact of the COVID pandemic upon patients' decisions to proceed with endoscopy upon practice re-opening is uncertain This study evaluated the frequency at which patients' consented to undergo endoscopies that were recommended during telemedicine appointments METHODS: A retrospective chart review of all patients seen during telemedicine appointments from March 16 through May 31, 2020 at an urban university medical center was conducted Patients who were advised to undergo endoscopy were identified Patient gender, self-identified race, insurance and recommended procedure were obtained Charts were reviewed to determine if the patient consented, deferred or declined the procedure A confidential database was created Analysis was performed using Fisher Exact test with statistical significance set at P 0 05 The study was approved by the IRB RESULTS: 229 patients (117 female, 112 male) were recommended endoscopy There were 92 African-American, 95 white, 10 Asian, 11 Hispanic, 12 with unknown race and 9 identified as other 129 had commercial insurance, 56 Medicare and 44 Medicaid 70 (30 5%) patients consented to the procedure, 111 (48 5%) deferred and 48 (21%) declined There was no significant difference in whether the patient consented to endoscopy based upon gender (P = 0 4738), race (P = 0 1546) or procedure type (P = 0 0791) However, patients with Medicare were significantly less likely to consent to endoscopy compared to patients with commercial insurance (P = 0 009) or Medicaid (P = 0 0275) CONCLUSION: Only 30% of telemedicine patients who were advised to undergo endoscopy consented to the procedure upon practice reopening during the COVID pandemic While safety measures mitigate COVID risk, patients frequently opted to defer or decline recommended endos-copy Medicare patients more often declined procedures, potentially due to concerns about age-related COVID complications While this study is limited based upon size and single institution design, it offers important information for practice re-opening Further study is needed to determine factors that influence patient decisions about scheduling endoscopy during the COVID pandemic