PD14-10 FREQUENCY AND TIMING OF EMERGENCY DEPARTMENT VISITS AND HOSPITAL ADMISSIONS FOLLOWING COMMON STONE PROCEDURES

Abstract

INTRODUCTION AND OBJECTIVE: Emergency department (ED) visits and hospital admissions (HA)following urologic procedures are a concern for payers, providers and patients. We seek to quantify ED visits and HA after percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), or shockwave lithotripsy (SWL). METHODS: A retrospective analysis was conducted using insurance claim data from the Truven Marketscan database. The analytic population included US adults age 18 or older with a urologic stone diagnosis and no history of urologic stone procedures in the prior 12 months, who underwent PCNL, URS, SWL, or a combination thereof (multiple) between 2012 and 2017 (index procedure). The frequency of all-cause ED visits or all-cause HA were evaluated during the 30, 60, 90, or 120-day periods after the index procedure. RESULTS: 74,388 patients with mean age of 53 years and 45% female gender were identified. Patients undergoing the index procedure in the inpatient setting were more likely to have a Charlson Comorbidity Index score of 2 or greater (30% vs 22%, P<0.001). Within 30 days after the index procedure, 17.5% of patients treated in the inpatient setting had an ED visit or HA compared to 12.1% for patients treated in the outpatient setting (P<0.001), Figures 1 and 2. In the outpatient setting, patients who underwent PCNL had higher rates of subsequent visits (16.6%) than did patients who underwent URS (12.1%), and URS patients had higher rates of subsequent ED visits or HAs than did SWL patients (11.4%; Chi-square P<0.001). CONCLUSIONS: Patients who undergo urologic stone procedures may be expected to visit the ED, or have an HA, within 30 days of the initial procedure, as infrequently as 11.4% of cases or as frequently as 20.3% . Urologists may be well-served to consider the incidence of all-cause healthcare utilization following urologic stone procedures. Future studies should seek to further define urologic issues related to ED visits and HAs.Source of Funding: Truven Marketscan database license supported by Becton Dickinson.