MP54-03 ASSESSING FOR VARIATIONS IN TIME TO SURGERY AFTER ED VISITS FOR STONE DISEASE

Abstract

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II (MP54)1 Sep 2021MP54-03 ASSESSING FOR VARIATIONS IN TIME TO SURGERY AFTER ED VISITS FOR STONE DISEASE Esther Nivasch Turner, Ruchika Talwar, Olivia Familusi, Katherine Michel, Jennifer Lloyd Harris, and Justin Ziemba Esther Nivasch TurnerEsther Nivasch Turner More articles by this author , Ruchika TalwarRuchika Talwar More articles by this author , Olivia FamilusiOlivia Familusi More articles by this author , Katherine MichelKatherine Michel More articles by this author , Jennifer Lloyd HarrisJennifer Lloyd Harris More articles by this author , and Justin ZiembaJustin Ziemba More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002084.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Disparities in nephrolithiasis care based on gender, ethnicity and age have been well described. Fewer studies have examined the influence of insurance status in nephrolithiasis treatment, but recent data suggests longer surgical wait times for patients without private insurance.[1] We conducted a self-audit to assess the effects of ethnicity and insurance on time to kidney stone surgery. METHODS: We retrospectively assessed all patients with evaluation of nephrolithiasis in the emergency room (ED), followed by definitive stone surgery (ureteroscopy/percutaneous nephrolithotomy/ESWL) at our major academic health system consisting of 3 hospitals in a dense, urban center, collecting information regarding insurance status and various demographic and clinical factors. RESULTS: In total, 601 patients underwent ED evaluation followed by surgery from 2017-2020 within our health system. Overall, 3.5% (n=23) were uninsured, 43% (n=282) were enrolled in federal healthcare (Medicare/Medicaid), and 54% (n=355) had private healthcare. Table 1 illustrates baseline, clinical, and disposition related characteristics. Median time to surgery overall was 36 days. Uninsured patients had a shorter time to surgery, with a median of 20 days (p=0.023). Private insurance was associated with lower rates of UTI (p=0.035) and sepsis (p=0.036). Patients with private insurance were more likely to be discharged from the ER (p=0.031). African American ethnicity was associated with longer time to surgery (Table 2, p<0.001), as well as stent placement upon ER presentation (p=0.05). CONCLUSIONS: Our study illustrates several important differences in the presentation and time to surgery for nephrolithiasis based on insurance and ethnicity. These findings can be used to inform treatment and patient counseling. Google Scholar Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e949-e949 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Esther Nivasch Turner More articles by this author Ruchika Talwar More articles by this author Olivia Familusi More articles by this author Katherine Michel More articles by this author Jennifer Lloyd Harris More articles by this author Justin Ziemba More articles by this author Expand All Advertisement Loading ...