Access to care and healthcare utilization among a diverse group of patients with nephrolithiasis

You have accessJournal of UrologyCME1 Apr 2023MP21-03 ACCESS TO CARE AND HEALTHCARE UTILIZATION AMONG A DIVERSE GROUP OF PATIENTS WITH NEPHROLITHIASIS Mouneeb Choudry, Kevin Wymer, Gopal Narang, Marlene Girardo, Mitchell Humphreys, and Karen Stern Mouneeb ChoudryMouneeb Choudry More articles by this author , Kevin WymerKevin Wymer More articles by this author , Gopal NarangGopal Narang More articles by this author , Marlene GirardoMarlene Girardo More articles by this author , Mitchell HumphreysMitchell Humphreys More articles by this author , and Karen SternKaren Stern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003246.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite the high prevalence of kidney stones, little data exist regarding the prevalence of barriers to obtaining appropriate treatment. We sought to use a diverse dataset to evaluate and characterize the impact of nephrolithiasis diagnosis and treatment on healthcare utilization. METHODS: We conducted a retrospective cohort study using the All of Us Database, an NIH database targeting recruitment of underrepresented US populations. Patients were included based on self-report of a diagnosis of kidney stones and were further categorized into surgical and non-surgical based on CPT codes. A control group without a diagnosis of nephrolithiasis was matched based on demographic and clinical characteristics. Primary outcomes were patients’ self-reported ability to access and afford care. Univariate and multivariable regression were performed. RESULTS: In total, 9,173 patients with a diagnosis of nephrolithiasis were included and matched to controls. Compared to controls, patients with kidney stones were less likely to have had >1 year since last provider visit (1.7% vs. 3.8%, p<.001), but did not report increased delays obtaining care, inability to afford care, or skipping medications. Among patients with a stone diagnosis, 1,208 (13.2%) had been treated with surgical intervention (SWL, URS, PCNL). A delay in care was reported by 31% , 11.4% could not afford care, 12.9% skipped medications, and 1.7% had not seen a provider in >1 year. On multivariable analysis, prior surgical intervention was not associated with barriers to care. However, younger age, female sex, black race, lower income, lower education level, and lower physical health score were associated with delays obtaining care, inability to afford care, and skipping medications (Table 1). CONCLUSIONS: A diagnosis of kidney stones, subsequent intervention, and race were not associated with a significant increase in patient-reported barriers to care. However, among patients with nephrolithiasis, those of black race, younger, comorbid, female patients from lower socioeconomic status are at significant risk of being unable to access treatment. Further research to target specific groups and interventions will help better understand health discrepancies. Source of Funding: Mayo Clinic Department of Urology © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e285 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mouneeb Choudry More articles by this author Kevin Wymer More articles by this author Gopal Narang More articles by this author Marlene Girardo More articles by this author Mitchell Humphreys More articles by this author Karen Stern More articles by this author Expand All Advertisement PDF downloadLoading ...