PD14-07 ASSOCIATION OF SOCIOECONOMIC FACTORS WITH REPEAT STONE SURGERY: DATA FROM THE REGISTRY FOR STONES OF THE KIDNEY AND URETER

Abstract

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II (PD14)1 Apr 2020PD14-07 ASSOCIATION OF SOCIOECONOMIC FACTORS WITH REPEAT STONE SURGERY: DATA FROM THE REGISTRY FOR STONES OF THE KIDNEY AND URETER Amy Showen*, David Bayne, Justin Ahn, Manuel Armas-Phan, Marshall Stoller, and Thomas Chi Amy Showen*Amy Showen* More articles by this author , David BayneDavid Bayne More articles by this author , Justin AhnJustin Ahn More articles by this author , Manuel Armas-PhanManuel Armas-Phan More articles by this author , Marshall StollerMarshall Stoller More articles by this author , and Thomas ChiThomas Chi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000848.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urolithiasis affects 1 in 11 Americans, and is associated with annual health care expenditures of up to $4.5 billion. Undergoing multiple as opposed to single procedures for urolithiasis confers additional risk to the patient and additional cost to the health care system. Both demographic characteristics (age <60 years, female gender) and clinical factors (malabsorption, diabetes, recurrent urinary tract infections, personal history of nephrolithiasis, and bilateral stones) predict undergoing multiple procedures. We aimed to determine socioeconomic factors (beyond age and gender) associated with repeat stone surgery. METHODS: We reviewed prospectively collected data from the Registry for Stones of the Ureter and Kidney (ReSKU) from 2015 to 2018. Patients ≥18 years with urolithiasis requiring procedural intervention and complete data were included. Socioeconomic variables of interest included race, education, language, mean income in zip code of residence, and healthcare access metrics (distance from tertiary care, urologist density in county of residence). The primary outcome was repeat surgery within 180 days of an index procedure for urolithiasis. Each socioeconomic variable was entered separately into a logistic regression model adjusted for age and gender. RESULTS: Complete data was available for 317 of 500 patients who underwent one or more procedures for urolithiasis. Of these 317 patients, 275 (87%) patients underwent a single procedure, and 42 patients (13%) underwent multiple procedures (Table 1). After controlling for age and gender, lower income and urologist density were associated with repeat surgery (p<0.05, Table 2). CONCLUSIONS: Our findings contribute to growing evidence for social determinants of urologic health. Conceptually, lower income and urologist density may impede timely access to high-quality urologic care, resulting in large or complex stones that require multiple procedures. From equity and cost perspectives, more research on the social determinants of urolithiasis is needed. Source of Funding: NIH grant P20-DK-116193 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e274-e275 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amy Showen* More articles by this author David Bayne More articles by this author Justin Ahn More articles by this author Manuel Armas-Phan More articles by this author Marshall Stoller More articles by this author Thomas Chi More articles by this author Expand All Advertisement PDF downloadLoading ...