Endoscopic ultrasound service readiness across a provincial endoscopy network in Hubei, China: a cross-sectional institutional survey

BackgroundEndoscopic ultrasound (EUS) is essential for pancreatobiliary evaluation, subepithelial-lesion assessment, tumor staging, and tissue acquisition. We evaluated EUS service availability, institutional resources, and quality-indicator reporting across a provincial endoscopy network in Hubei, China.MethodsWe conducted a cross-sectional survey of 99 digestive endoscopy institutions from January to March 2026. Institutions were classified by administrative level and four mutually exclusive capability tiers: no EUS, miniprobe-only EUS, diagnostic radial/linear EUS without EUS-FNA, and EUS-guided fine-needle aspiration (EUS-FNA). Analyses included descriptive statistics, Wilson 95% confidence intervals, and exploratory univariable associations.ResultsAny EUS service was reported by 33/99 institutions (33.3%). Of these, 16 provided miniprobe-only EUS, 6 provided diagnostic radial/linear EUS without EUS-FNA, and 11 provided EUS-FNA. The diagnostic radial/linear and EUS-FNA tiers together comprised 17 institutions with radial/linear EUS capability, all of which were city-level hospitals. Median annual endoscopy volume was 1,518.5 (IQR, 309.3-4,000) in the no-EUS tier and 21,293 (IQR, 10,032-29,810.5) in the EUS-FNA tier; corresponding endoscopist counts were 4 (IQR, 2-6) and 14 (IQR, 11-19.5). The eight highest-volume institutions accounted for 81.9% of reported EUS activity. EUS completion-rate reporting was present in 30/33 EUS providers (90.9%), and EUS-FNA pathological-yield reporting in 9/11 EUS-FNA providers (81.8%).ConclusionsEUS services in the participating network were concentrated in city-level hospitals, with higher median annual endoscopy volume and endoscopist staffing in the higher capability tiers. These findings describe service provision within the surveyed institutions and identify questions for future evaluation of referral, training, and quality monitoring.