Abstract

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes Measures I (MP17)1 Sep 2021MP17-15 FREQUENCY AND TIMING OF EMERGENCY DEPARTMENT VISITS AND HOSPITAL ADMISSIONS FOLLOWING COMMON STONE PROCEDURES Rohail Rashid Kazi, Molly Jung, Yan Xiong, Timothy Kelly, and Andrew Harris Rohail Rashid KaziRohail Rashid Kazi More articles by this author , Molly JungMolly Jung More articles by this author , Yan XiongYan Xiong More articles by this author , Timothy KellyTimothy Kelly More articles by this author , and Andrew HarrisAndrew Harris More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002002.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Emergency department (ED) visits and hospital admissions (HA) following urologic procedures are a concern for payors, providers, and patients. We seek to quantify ED visits and HA after urologic stone procedures. METHODS: A retrospective analysis was conducted using claims data from IBM MarketScan Commercial and Medicare Supplement databases. Adults with urologic stone diagnosis and no history of stone procedure in prior 12 months who underwent percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), or shockwave lithotripsy (SWL) and had ureteral stent codes during the index procedure between 2012 and 2017 were analyzed. All cause vs GU-specific ED visits and HA were evaluated during 30, 60, 90, and 120-day periods. RESULTS: 88,047 patients with mean age of 52.6 years and 44% female gender were identified that met inclusion criteria. Of these patients, 8,924 (10%) had their index procedure as an inpatient and 79,123 (90%) as an outpatient. For inpatients, rate of all cause vs GU-specific ED visits was 10% vs 9% at 30 days, 14% vs 12% at 60 days, 16% vs 14% at 90 days, and 19% vs 15% at 120 days. For outpatients, rate of all cause vs GU-specific ED visits was 9% vs 8% at 30 days, 11% vs 10% at 60 days, 13% vs 11% at 90 days, and 15% vs 12% at 120 days. A similar trend was found when examining rate of all-cause vs GU-specific HA. Younger patients (18-44 years old) tended to have higher rates of ED visits than older patients (>65 years old) following inpatient index stone procedure (13.4% vs 9.6% at 30 days, p ≤0.01). Patients with CCI ≥2 had higher rates of unplanned ED visits following stone procedures compared with those with CCI = 0 (11.3% vs 9.7%, p <0.01). CONCLUSIONS: Nearly one-fifth of patients have an unplanned hospital visit up to 120 days after having stone procedure, regardless of site of treatment. The majority of these visits involve GU-related diagnoses. Younger patients and patients with higher number of comorbidities have unplanned hospital visits in greater proportion than older patients and patients with fewer comorbidities. Further studies need to determine causation of these unplanned visits in order to guide appropriate intervention. Source of Funding: IBM Marketscan Database information provided by BD © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e314-e314 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rohail Rashid Kazi More articles by this author Molly Jung More articles by this author Yan Xiong More articles by this author Timothy Kelly More articles by this author Andrew Harris More articles by this author Expand All Advertisement Loading ...

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