PD29-04 EVOLUTION OF HEALTHCARE COSTS FOR LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation (PD29)1 Apr 2020PD29-04 EVOLUTION OF HEALTHCARE COSTS FOR LOWER URINARY TRACT SYMPTOMS ASSOCIATED WITH BENIGN PROSTATIC HYPERPLASIA Charles Welliver*, Julia B. Ward, Lydia Feinstein, Kevin C. Abbott, Tamara Bavendam, Ziya Kirkali, Erline Martinez-Miller, Brian R. Matlaga, and Kevin McVary Charles Welliver*Charles Welliver* More articles by this author , Julia B. WardJulia B. Ward More articles by this author , Lydia FeinsteinLydia Feinstein More articles by this author , Kevin C. AbbottKevin C. Abbott More articles by this author , Tamara BavendamTamara Bavendam More articles by this author , Ziya KirkaliZiya Kirkali More articles by this author , Erline Martinez-MillerErline Martinez-Miller More articles by this author , Brian R. MatlagaBrian R. Matlaga More articles by this author , and Kevin McVaryKevin McVary More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000893.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Evolving management of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) has changed the distribution of healthcare spending. Our understanding of recent trends in LUTS/BPH management costs is incomplete given prior studies have been limited to older men, small datasets, and inpatient procedures. We characterized LUTS/BPH-related Medicare and private insurance expenditures over 10 years. METHODS: As part of the Urologic Diseases in America project, we analyzed two insurance claims databases: the Centers for Medicare & Medicaid Services Medicare 5% Sample for male Medicare beneficiaries aged ≥65 years with LUTS/BPH (N≈147,800 annually) and the Optum© de-identified Clinformatics® Data Mart Database (CDM) for privately insured males aged 40-64 years with LUTS/BPH (N≈100,300 annually). Annual LUTS/BPH-related expenditures from 2004-2013 were examined by service location: inpatient, hospital-based outpatient, and physician office. RESULTS: The average annual LUTS/BPH-related expenditures were $305 and $248 per LUTS/BPH patient in CDM and Medicare, respectively. Over the 10-year study period, inpatient care accounted for a decreasing percentage of total dollars spent on managing LUTS/BPH by Medicare (30% to 15%) and private insurance (37% to 15%). Outpatient LUTS/BPH-related expenditures rose for both insurer groups, especially for private insurance (61% to 83%). Expenditures for hospital-based outpatient care rose over the study period and exceeded physician office expenditures from 2007 onward for patients with private insurance, and from 2010 onward for Medicare patients (Figure). CONCLUSIONS: The distribution of healthcare expenditures for LUTS/BPH shifted across practice settings from 2004-2013, with increasing outpatient relative to inpatient expenditures. Hospital-based outpatient expenses exceeded physician office expenses, likely due to increased use of ambulatory surgical procedures for LUTS/BPH. In-office minimally invasive surgical therapies will likely lead to higher physician office costs in the future. Differences in expenditures between the study populations may be due to differential reimbursement practices between private insurance and Medicare. Source of Funding: Funded by the NIH via a contract to Social & Scientific Systems. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e619-e619 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Charles Welliver* More articles by this author Julia B. Ward More articles by this author Lydia Feinstein More articles by this author Kevin C. Abbott More articles by this author Tamara Bavendam More articles by this author Ziya Kirkali More articles by this author Erline Martinez-Miller More articles by this author Brian R. Matlaga More articles by this author Kevin McVary More articles by this author Expand All Advertisement PDF downloadLoading ...