Critical shortage of gastrointestinal physician density in the USA: impact on mortality from upper gastrointestinal bleeding
By
Abuoma Cherry Ekpendu
Muhammad Sohaib Asghar
Waqar Qureshi
Rohin Patel
Pankajkumar Patel
Chad K. Brands
June 15, 2026
Clinical Scorecard: Insufficient Availability of Gastrointestinal Specialists in the United States: Consequences for Mortality Rates Associated with Upper Gastrointestinal Bleeding
At a Glance
Category Detail
Condition Upper Gastrointestinal Bleeding (UGIB) Key Mechanisms Gastrointestinal physician density (GIPD) significantly associated with UGIB mortality rates. Target Population Individuals experiencing upper gastrointestinal bleeding, particularly older adults and vulnerable populations. Care Setting Healthcare systems in the United States.
Key Highlights
Overall crude mortality rate (CMR) for UGIB was 12.1 per 100,000 population from 1999 to 2023. Age-adjusted mortality rates (AAMRs) were 11.0 per 100,000 population. Mortality rates increased from 2018 to 2021 and decreased from 2021 to 2023. GIPD was significantly associated with higher UGIB mortality rates, while PCPD showed no association. Highest CMRs were observed in older age groups, American Indian or Alaska Native populations, and rural communities. Guideline-Based Recommendations
Diagnosis
Identify UGIB using ICD-10 codes. Assess demographic and geographic factors influencing UGIB mortality. Management
Consider the density of gastrointestinal specialists in managing UGIB cases. Monitoring & Follow-up
Monitor trends in UGIB mortality rates across different demographics and regions. Risks
Higher mortality rates associated with lower GIPD. Patient & Prescribing Data
Patients with upper gastrointestinal bleeding.
Management strategies should consider the availability of gastrointestinal specialists.
Clinical Best Practices
Utilize CDC WONDER database for accurate mortality data. Focus on increasing GIPD to improve UGIB outcomes. Related Resources & Content
