PD10-08 COMPLIANCE AND METABOLIC STONE DISEASE. DOES DISTANCE TO CARE MATTER?

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III1 Apr 2016PD10-08 COMPLIANCE AND METABOLIC STONE DISEASE. DOES DISTANCE TO CARE MATTER? Maxx Gallegos and Julie Riley Maxx GallegosMaxx Gallegos More articles by this author and Julie RileyJulie Riley More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2916AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Due to a dry climate and unique patient demographic, metabolic stone disease is prevalent in New Mexico. University of New Mexico Hospital is the only tertiary referral center for urologic disease in the state, therefore, comprehensive stone surveillance and treatment is crucial. It has been anecdotally suggested that distance from a care center is a factor in patient noncompliance. Our study aims to show this phenomenon. METHODS All upper tract stone diagnoses of the last 5 years were reviewed, including patients who received medical expulsive therapy, ureteroscopy or percutaneous nephrolithotomy. Of those, only patients who submitted a 24-hour urine for metabolic stone surveillance were analyzed. This yielded 225 unique patients for final review. Compliance with follow up was determined by chart review. Patients were stratified into groups based on their distance from UNMH. Fisher tests and odds ratios were used to compare groups. RESULTS One hundred fifty seven were compliant with follow up while 68 were not. Patients were more likely to be compliant who lived within 40 miles (OR: 4.45, CI: 2.03 – 9.61, P = 0.0002), 30 miles (OR: 3.83, CI: 2.05 – 7.16, P < 0.0001), and 20 miles (OR: 3.83 CI: 2.09 – 7.02, P < 0.0001) of our institution. In contrast, those living within 15 miles of UNMH were not statistically different than all other patients living farther away (OR: 0.66, CI: 0.37-1.19, P=0.17). CONCLUSIONS Urolithiasis is a common problem in the southwest United States, and the need for comprehensive follow up care is crucial for treatment. To our knowledge, this is the first study of its kind to show how distance from point of care relates to compliance in stone disease. Patients living greater than 20 miles from our center demonstrated significantly decreased compliance. Stone disease is distressing to patients and economically costly, and our study highlights the need for further research in strategies to improve compliance. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e241-e242 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Maxx Gallegos More articles by this author Julie Riley More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...