Objectives: To describe the utilization of SWL and URS in ambulatory surgery centers, as well as to identify patient specific factors predictive of one procedure over the other.
Subjects and Methods: We evaluated the current trends in the utilization of SWL and URS in the ambulatory settings over 5 year period in the state of California utilizing the State of California Office of Statewide Health Planning and Development (OSHPD) database.
Results: We identified 113,447 ambulatory kidney stone surgeries including 64,632 SWL (57%) and 48,815 URS (43%) treatments in the OSHPD database between 2005 and 2010. The total annual ambulatory stone surgeries increased from 17,831 cases in 2005 to 18,933 cases in 2010 (p< 0.001). Between 2005 and 2010, the use of URS increased significantly from 6,978 (39%) cases in 2005 to 9,259 (49%) cases in 2010 (p< 0.0012), whereas the use of SWL decreased from 10,853 (61%) cases in 2005 to 9,674 (51%) cases in 2010 (p=0.0012). In multivariate analysis, age ≥75 years (p< 0.001), hypertension (p=0.025), and obesity (p< 0.001) all increased odds of undergoing URS. In addition, men (p=0.013) and non-Medicaid patients (p< 0.001) were more likely to undergo URS.
Conclusions: The use of URS increased significantly in the state of California among patients undergoing urinary stone surgery in the ambulatory setting, while the use of SWL decreased between 2005 and 2010. Possible explanations for these trends include improved URS stone free rates, improved cost effectiveness of URS, and enhanced technology leading to increased utilization of URS over SWL.
Written by:
Raheem O, Mirheydar HS, Miller D, Palazzi-Churas K, Chang D, Sur RL. Are you the author?
UC San Diego, Urology, 200 W Arbor Dr, San D, UCSD urology, San Diego, California, United States, 92103.
Reference: J Endourol. 2015 Apr 7. Epub ahead of print.
doi: 10.1089/end.2015.0129
PubMed Abstract
PMID: 25849858