Dataset Information

Payer Type, Race/Ethnicity, and the Timing of Surgical Management of Urinary Stone Disease.

ABSTRACT:

Purpose

Surgery for upper tract urinary stone disease is often reserved for symptomatic patients and those whose stone does not spontaneously pass after a trial of passage. Our objective was to determine whether payer type or race/ethnicity is associated with the timeliness of kidney stone surgery.

Materials and methods

A population-based cohort study was conducted using the California Office of Statewide Health Planning and Development dataset from 2010 to 2012. We identified patients who were discharged from an emergency department (ED) with a stone diagnosis and who subsequently underwent a stone surgery. Primary outcome was time from ED discharge to urinary stone surgery in days. Secondary outcomes included potential harms resulting from delayed stone surgery.

Results

Over the study period, 15,193 patients met the inclusion criteria. Median time from ED discharge to stone surgery was 28 days. On multivariable analysis patients with Medicaid, Medicare, and self-pay coverage experienced adjusted mean increases of 46%, 42%, and 60% in time to surgery, respectively, when compared with those with private insurance. In addition, patients of Black and Hispanic race/ethnicity, respectively, experienced adjusted mean increases of 36% and 20% in time to surgery relative to their White counterparts. Before a stone surgery, underinsured patients were more likely to revisit an ED three or more times, undergo two or more CT imaging studies, and receive upper urinary tract decompression.

Conclusions

Underinsured and minority patients are more likely to experience a longer time to stone surgery after presenting to an ED and experience potential harm from this delay.

SUBMITTER: Brubaker WD

PROVIDER: S-EPMC6388711 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Payer Type, Race/Ethnicity, and the Timing of Surgical Management of Urinary Stone Disease.

Brubaker William D WD Dallas Kai B KB Elliott Christopher S CS Pao Alan C AC Chertow Glenn M GM Leppert John T JT Conti Simon L SL

Journal of endourology 20181116 2

<h4>Purpose</h4>Surgery for upper tract urinary stone disease is often reserved for symptomatic patients and those whose stone does not spontaneously pass after a trial of passage. Our objective was to determine whether payer type or race/ethnicity is associated with the timeliness of kidney stone surgery.<h4>Materials and methods</h4>A population-based cohort study was conducted using the California Office of Statewide Health Planning and Development dataset from 2010 to 2012. We identified pat ...[more]

PMID: 30343603

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Dataset Information

Payer Type, Race/Ethnicity, and the Timing of Surgical Management of Urinary Stone Disease.

Purpose

Materials and methods

Results

Conclusions

Publications

Payer Type, Race/Ethnicity, and the Timing of Surgical Management of Urinary Stone Disease.

Similar Datasets

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