Abstract
Objectives
To quantify emergency department (ED) visits and hospital admissions (HA) after common
urologic stone procedures including ureteroscopy (URS), shockwave lithotripsy (SWL),
and percutaneous nephrolithotomy (PCL) which are a concern of payors, providers, and
patients.
Materials and Methods
This is a retrospective cohort study using claims data from the IBM MarketScan Commercial
and Medicare Supplement databases. Adults with a urologic stone diagnosis and no history
of stone procedure in prior 12 months who underwent stone procedures between 2012
and 2017 were included. All-cause ED visits and HA were evaluated during 30, 60, 90,
and 120-day periods following the index urologic stone procedure.
Results
166,287 patients were included in the analytic cohort. For inpatient-indexed procedures,
cumulative ED visits rates following stone procedure at 120 days was 18.8% for URS,
19.2% for SWL, and 23.6% for PCL. A similar trend was observed with ED visit rates,
following outpatient indexed procedures at 120 days with a cumulative rate of 14.2%
of SWL patients, 14.9% of URS patients, and 17.3% of PCL. A similar trend was found
when examining HA. ED and HA rates increased steadily through the 120-day time period.
Conclusion
Rates of ED visits and HA following common stone procedures continue to rise at least
up to 120 days following the index procedure whether in the outpatient or inpatient
settings. While rates of unplanned care are similar for URS and SWL, patients undergoing
PCL return to the hospital at higher rates.
Key Words
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Article info
Publication history
Accepted:
February 28,
2023
Received:
October 20,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Declarations of Interest: None.
Competing Interests: None.
Support/Financial Disclosures: Becton-Dickinson funded and assembled the data from the IBM MarketScan Commercial and Medicare Supplement databases.
Identification
Copyright
© 2023 Elsevier Inc. All rights reserved.
