BACKGROUND AND PURPOSE: We sought to examine a large nationwide (United States) sample of ED visits to determine data related to utilization and costs of care for urolithiasis in this setting.
METHODS: NEDS was analyzed from 2006-2009. All patients presenting to the ED with a diagnosis of upper tract urolithiasis were analyzed. Admission rates and total cost were compared by region, hospital type, and payer type. Numbers are weighted estimates designed to approximate the total national rate.
RESULTS: An average of 1.2 million patients per year were identified with the diagnosis of urolithiasis out of 120 million visits to the ED annually. Overall average rate of admission was 19.21%. Admission rates were highest in the Northeast (24.88%), among teaching hospitals (22.27%), and among Medicare patients (42.04%). The lowest admission rates were noted for self-pay patients (9.76%) and non-metropolitan hospitals (13.49%). The smallest increases in costs over time were noted in the Northeast. Total costs were least in non-metropolitan hospitals, however, more patients were transferred to other hospitals. When assessing hospital ownership status, private for profit hospitals had similar admission rates compared to private not-for profit hospitals (16.6% versus 15.9%), however costs were 64% and 48% higher for ED and inpatient admission costs respectively.
CONCLUSIONS: Presentation of urolithiasis to the ED is common, and is associated with significant costs to the medical system which are increasing over time. Costs and rates of admission differ by region, payer type, and hospital types, which may allow us to identify causes for cost discrepancies and areas to improve efficiency of care delivery.
Written by:
Eaton SH, Cashy J, Pearl JA, Stein DM, Perry K, Nadler RB. Are you the author?
Northwestern University, Department of Urology, 675 North St. Clair, 20th floor Suite 150, Chicago, Illinois, United States, 60611.
Reference: J Endourol. 2013 Sep 2. Epub ahead of print.
doi: 10.1089/end.2013-0205.ECC13
PubMed Abstract
PMID: 23998803
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