MP10-13 ONGOING IMPROVEMENT IN ACCESS AND QUALITY OF CARE FOR KIDNEY STONE PATIENTS IN AN UNDERSERVED COMMUNITY: A THREE YEAR PROGRAM UPDATE

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP10-13 ONGOING IMPROVEMENT IN ACCESS AND QUALITY OF CARE FOR KIDNEY STONE PATIENTS IN AN UNDERSERVED COMMUNITY: A THREE YEAR PROGRAM UPDATE Megan Stout, Molly McNamara, Aliza Khuhro, Matthew Murtha, Max Yudovich, Alicia Scimeca, Dinah Diab, Tasha Posid, Ganesh Shidham, Elizabeth Weinandy, Bodo Knudsen, and Michael Sourial Megan StoutMegan Stout More articles by this author , Molly McNamaraMolly McNamara More articles by this author , Aliza KhuhroAliza Khuhro More articles by this author , Matthew MurthaMatthew Murtha More articles by this author , Max YudovichMax Yudovich More articles by this author , Alicia ScimecaAlicia Scimeca More articles by this author , Dinah DiabDinah Diab More articles by this author , Tasha PosidTasha Posid More articles by this author , Ganesh ShidhamGanesh Shidham More articles by this author , Elizabeth WeinandyElizabeth Weinandy More articles by this author , Bodo KnudsenBodo Knudsen More articles by this author , and Michael SourialMichael Sourial More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003225.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a call to improve Medicaid patient access to healthcare, enhance quality and outcomes of care, and reduce overall financial burden. We sought to build a comprehensive kidney stone program to help patients navigate through the acute and preventative aspects of stone disease by increasing multidisciplinary referrals, compliance to recommendations, no-show rates at first follow-up, and repeat stone encounters after initial evaluation. METHODS: A collaborative, multi-disciplinary program was established at our single institution consisting of urology, nephrology, and dietary specialists to be piloted over a three-year period. Medicaid-designated patients were evaluated for during new patient encounters by urology and then followed for outpatient follow-up including specialty referrals to nephrology and dietitians when indicated for targeted preventative measures. Subjective compliance reports by patients following interventions and no-show rates at subsequent follow-ups were documented. We also followed patients 6 months beyond initial encounter to assess for repeat Emergency Department (ED) visits for acute stone episodes. RESULTS: One hundred and eighty-three Medicaid-designated stone patients were evaluated from 2018-2021. Sixty-eight percent of patients identified as white, 18% identified as black/African-American, and 14% identified as “other”. Patients underwent specialty referrals to nephrology or a dietician in 47% and 42% of cases, respectively. Since the program’s implementation, reported patient compliance and referrals to multidisciplinary specialists increased from 72.9% to 81.3% and 21.2% to 56.2%, respectively. Repeat Emergency Department visits for stone related encounters within 6 months of initial presentation remained relatively stable (from 17.6% to 18.9%) while no-show rates at first follow-up decreased from 20.0% to 6.3% by study conclusion. CONCLUSIONS: There is continued supporting evidence for the importance of a comprehensive kidney stone program specifically for patients of lower socioeconomic status following a three-year implementation at our institution. Encouraging results indicate increased access to multi-disciplinary specialty referrals, with improvement in follow-up and reported compliance related to stone prevention strategies. Source of Funding: The Upper Payment Limit Grant of The Ohio State University © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e119 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Megan Stout More articles by this author Molly McNamara More articles by this author Aliza Khuhro More articles by this author Matthew Murtha More articles by this author Max Yudovich More articles by this author Alicia Scimeca More articles by this author Dinah Diab More articles by this author Tasha Posid More articles by this author Ganesh Shidham More articles by this author Elizabeth Weinandy More articles by this author Bodo Knudsen More articles by this author Michael Sourial More articles by this author Expand All Advertisement PDF downloadLoading ...