Epidemiology and treatment of inpatients urolithiasis in Taiwan

Abstract

Background/IntroductionUrolithiasis is a common disease with high prevalence and recurrence rates in Taiwan. A national survey in Taiwan determined that 9.6% of the population suffered stones throughout their lifetime. Purpose/AimThis study analyzed the epidemiological characteristics and patterns of inpatient treatment for urolithiasis and thus provides a reference for the implementation of future health strategies. MethodsA cross-sectional study was conducted using data collected from the Inpatient Expenditures by Admissions and Registry for Contracted Medical Facilities files of the National Health Insurance Research Database. A total of 40,027 patients were included in the final data analysis. SPSS 22.0 statistical software was used to analyze the epidemiological characteristics and corresponding treatments for each patient group. ResultsThe average age of the inpatients with urolithiasis was 52 ± 14 years, with a male-to-female sex ratio of 2.4:1. The highest admission rate occurred between July and August (10.4–10.6%). Ureteral stones were the most common (76.4%), followed by kidney stones (15.8%), bladder stones (7.5%), and urethral stones (0.4%). Moreover, 57.4% of the patients were treated at regional hospitals and 27.5% were treated at medical centers. Of the 4531 urolithiasis examinations conducted, 63.6% involved intravenous urography, 21.8% abdominal sonography, and 5.9% retrograde pyelography. In total, 13,610 treatments were performed in the 40,027 inpatients with urolithiasis, with a surgical treatment rate of 34%. Extracorporeal shock wave lithotripsy (ESWL) is the most commonly used treatment for patients with renal or ureteral stones with an annual medical expenditure of nearly NT $3 billion. Regional hospitals conducted the highest number of ESWL treatment for inpatients with stones, whereas medical centers conducted more percutaneous nephrostomy lithotripsy than did regional hospitals. ConclusionThis study reveals patterns in the epidemiology and utilization of medical resources for inpatients with urolithiasis and provides a basis for the implementation of stone treatment guidelines in Taiwan.