Impact of public-private partnership on a regional colonoscopy service.

BACKGROUND: A public-private partnership for endoscopy was introduced in Geelong where there was no capacity for public hospital endoscopy lists to expand. This paper presents the impact of this partnership on colonoscopy services. METHODS: Data were collated from prospectively maintained databases. Wait-times to outpatient appointments, colonoscopy and follow-up were analysed between July 2015 and June 2017 allowing for a 12-month period of analysis before and after the initiation of the contract. Data are presented as medians (interquartile range). RESULTS: A total of 1300 colonoscopies were done between July 2015 and June 2016 compared to 2114 colonoscopies (P < 0.01) after the initiation of the public-private contract; 1073 (51%) colonoscopies were done on private contract. Prior to public-private contract, 41% patients waited more than 120 days from first presentation to healthcare services to diagnostic colonoscopy, this decreased to 19% after. Improvements were seen in both the waiting time for outpatient consultation (reduced from 92 days (39-136) prior to July 2016 to 73 days (32-122); P < 0.01) after) and the time taken from consultation to colonoscopy (from 125 days (70-207) to 36 days (21-159); P < 0.01) for category 1 patients. CONCLUSION: Wait-times for both specialist outpatient assessment and colonoscopy have been significantly reduced through the introduction of a unique public-private partnership in the Greater Geelong area, resulting in more timely access for public patients and improved compliance with new guidelines.