Objective To determine the proportion of intravenous anesthesia (IVA) used in gastrointestinal endoscopy (GIE) and factors associated with its utilization, and to evaluate the health awareness of patients and its impact on medical treatment-seeking behavior.

Methods This retrospective, single-center study included patients aged over 18 years who underwent GIE examinations in Zhongshan Hospital, Fudan University from January 1, 2012 to December 31, 2017. The main parameters were the proportion of IVA utilization for gastrointestinal endoscopies and the associated factors which determined the IVA use. Logistic regression was used to explore the association between patient and procedure characteristics and utilization of IVA.

Results The average proportion of GIE with IVA use was 55.5%. Factors associated with IVA included non-Shanghai hukou (registered permanent residence)-holders (odds ratios ORs for non-Shanghai hukou-holders with stable jobs, patients from high, middle, low income provinces, and patients staying at Shanghai temporarily vs native Shanghai residents: 2.47, 1.42, 1.16, 1.17 and 1.39, respectively); younger age (ORs for age groups 46-65 years, 66-85 years, and >85 years vs patients aged 18-45 years: 0.96, 0.77 and 0.50, respectively); colonoscopy (ORs for colonoscopy vs gastroscopy, 3.45, 95% CI 3.41-3.50); physical examination (ORs for medical complains group and pre-/post-operative evaluation group vs physical examination: 0.55 and 0.60, respectively).

Conclusions Compared to Shanghai hukou-holders, non-Shanghai hukou-holders are more willing to pay for the IVA in GIE. The low selection rate of IVA in GIE of elderly patients suggests that there is much room for improvement, and reducing the economic burden of using IVA may promote more people to undergo GIE examination and choose IVA.