(214) National Trends of Inpatient vs. Outpatient Male Benign Prostate Hyperplasia Procedures: 2016-2019

Abstract

Abstract Introduction Benign prostatic hyperplasia (BPH) is a common condition among aging men, causing urinary symptoms and impacting quality of life. Understanding the trends in BPH treatment procedures is crucial for optimizing patient care. Evaluating the utilization of different treatments, the setting of procedures (inpatient vs. outpatient), and associated costs can provide valuable insights. Identifying patient- and hospital-level factors associated with inpatient treatments can help identify disparities in access to care. Assessing the financial implications of care settings can optimize resource allocation. This research aims to contribute to knowledge by providing comprehensive insights into BPH treatment patterns, patient demographics, and healthcare costs for informed decision-making and improved patient outcomes. Objective To evaluate contemporary national trends of BPH treatment procedures among men. Methods An analysis of BPH treatment procedures performed from 2016-2019 was conducted utilizing both the National Inpatient Sample (NIS) and the Nationwide Ambulatory Surgery Sample (NASS). BPH treatment procedures were identified by Current Procedural Terminology (CPT) and International Classification of Diseases (10th Revision) Procedure Coding System (ICD-10-PCS) codes. Stratified cluster sampling was used to create weighted national estimates. The primary outcome was the rate of BPH treatments procedures performed in inpatient and outpatient encounters over time. Multivariable logistic regression was used to evaluate patient- and hospital-level factors associated with inpatient BPH treatments. Results A total of 811,111 weighted BPH treatment procedures analyzed showed that 45% of procedures were performed inpatient, with the remaining 55% performed outpatient over the course of 2016-2019 (Figure 1). Regional analysis revealed a majority of procedures were performed in the South at 36% and about 40% inpatient and outpatient, respectively (Table 1). The proportion of BPH procedures performed outpatient remained stable at 55% from 2016-2019 (Figure 1). The average age of a treated patient was similar between 66 inpatient and 70 outpatient. Multivariable logistic regression analysis showed an Elixhauser Comorbidity Index greater than 0 as a predictor of inpatient BPH treatment (Table 2). Medicare was the primary payer for both inpatient and outpatient settings at 51% and 60% respectively. Mean total charge for inpatient BPH encounters was $70,061 vs. $22,716 outpatient. Conclusions A sizable majority of BPH treatment procedures nationwide appear to be performed in an outpatient setting. Outpatient procedures have a lower total charge compared to inpatient care, which appears to be a contributing factor. Most inpatient procedures are more likely to be performed on patients. Further investigation is warranted to assess how these factors may affect surgical outcomes. Disclosure No.