You have accessJournal of UrologyHealth Services Research: Practice Patterns, Quality of Life and Shared Decision Making I (PD03)1 Sep 2021PD03-01 RACIAL AND ETHNIC DISPARITIES IN EMERGENCY CARE AMONG PATIENTS WITH URINARY STONE DISEASE Joshua Hayden, Hui-Jie Lee, and Charles Scales Joshua HaydenJoshua Hayden More articles by this author , Hui-Jie LeeHui-Jie Lee More articles by this author , and Charles ScalesCharles Scales More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001967.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Symptomatic urinary stone disease is a common cause for emergency department (ED) visits; for some patients, ED revisits often occur before cessation of a stone episode. Little is known regarding how non-clinical factors such as patient race, ethnicity, or insurance status contribute to ED revisit for stone disease. We sought to identify associations between ED revisit and patient race/ethnicity. METHODS: This was a retrospective cohort study of patients in Florida, Georgia, and Maryland who had initial ED treat-and-release visits for urinary stone disease utilizing the state-specific Healthcare Cost and Utilization Project (HCUP) databases between 2016-2017. A repeat ED visit for urinary stones within 30 days of an initial ED encounter was the primary outcome. A generalized estimating equation with a logit link that accounted for hospital-level clustering was employed, using race/ethnicity as the primary predictor and adjusting for other covariates such as age, sex, and primary payer. Race and ethnicity were reported as a single variable by HCUP, with ethnicity taking precedence over race in the assignment; categories were White, Hispanic, Black, and Other/Unknown. RESULTS: Of the 209,309 patients who had an initial treat-and-release ED visit for symptomatic urinary stones, 14,853 (7.1%) had at least one additional ED encounter for symptomatic stones within 30 days of their initial ED visit. Revisit percentages differed among racial/ethnic groups (White 7.5%, Hispanic 6.8%, Black 5.7%, p < 0.001). Black (adjusted odds ratio (aOR) 0.72, 95% confidence interval (CI) 0.67 to 0.76) and Hispanic (aOR 0.88, 95% CI 0.82 to 0.94) individuals were less likely to revisit than White individuals. Primary insurance coverage with Medicaid compared to private insurance (aOR 1.49, 95% CI 1.41 to 1.57), and rural residence compared to large metropolitan (aOR 1.13, 95% CI 1.02 to 1.25) were associated with increased odds of revisit. CONCLUSIONS: In this cohort, repeat emergency care for symptomatic urinary stones affects 7.1% of patients after initial stone management in the ED setting. Race/ethnicity was associated with stone-related ED revisit. To understand the revisit discrepancies, further investigation into potential explanations of observed race/ethnicity-associated care patterns following initial ED encounters for urinary stones is warranted. Source of Funding: N/A © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e43-e43 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Hayden More articles by this author Hui-Jie Lee More articles by this author Charles Scales More articles by this author Expand All Advertisement Loading ...