PTH-047 Evaluation of Patient Satisfaction Following Percutaneous Endoscopic Gastrostomy (PEG) Insertion: Day Case Versus In-patient Model in UHCW NHS Trust

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In patients with head and neck (HandN) cancer, standard practice is to insert a prophylactic gastrostomy tube to optimise nutrition and enable nutrition support during treatment. Although traditionally an inpatient procedure, many are now treated as outpatients, allowing a more time and cost effective service. There is very little data however regarding patient satisfaction with this move to a day case model.


Having recently introduced a new day case PEG service for HandN cancer patients in UHCW NHS Trust, we wanted to evaluate the service and compare patient satisfaction levels in both in-patient and day case cohorts.


We selected 20 sequential HandN patients who had undergone a day case PEG procedure since the day case service was introduced in March 2013. For comparison, we identified a further 20 sequential HandN patients who had undergone PEG insertion as an in-patient during the previous 12-months (Oct 2012 to Sep 2013). Deceased patients were excluded. A modified GHAA-9 questionnaire was used to assess patient satisfaction with the procedure [1]. This questionnaire was sent out retrospectively, and a pre-paid reply envelope was included with the questionnaire. Patients not responding within 1-month were telephoned to ask if they wished to complete the feedback survey.


Day case patients (n = 20) were aged 40–70 yrs (mean 54); 80% male. In-patients (n = 20) were aged 42–81 yrs (mean 60); 59% male. 75% of the day case PEGs were inserted prior to cancer treatment start, versus 45% of in-patient procedures. Those undergoing in-patient insertions utilised 53 bed-days collectively. No patient from either cohort was admitted within 7 or 30 days. There were no major complications in either group.


Patient satisfaction questionnaires were returned by 26 (65%): 11 in-patients (55%) and 15 day case (75%). Mean satisfaction score for day case was 36.3 ± 3.8, whereas mean score for in-patients was 32.7 ± 7.8 (max score = 40). Only 1.7% day case patients identified aspects of their PEG procedure that were fair/poor, compared to 7.9% in-patients. In-patients described higher dissatisfaction relating to time from referral to insertion, and delays waiting for insertion once admitted.


Our results suggest greater overall satisfaction in patients undergoing PEG insertion as a day case, with no increase in complications. Moreover the PEG was undertaken in a more timely fashion with the majority (75%) having their PEG inserted prior to treatment start. 53 patient bed days were saved for just 20 procedures which represent a cost saving to the Trust of approximately £13,992[2].


1 Harewood et al.Am J Gast 2003;98:1016–1021



Disclosure of Interest

None Declared.

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