PD47-06 DISPROPORTIONATE USE OF INPATIENT CARE BY OLDER ADULTS WITH URINARY STONE DISEASE (2016)

You have accessJournal of UrologyStone Disease: Epidemiology & Evaluation II1 Apr 2016PD47-06 DISPROPORTIONATE USE OF INPATIENT CARE BY OLDER ADULTS WITH URINARY STONE DISEASE Eugene B Cone, Brad Hammill, Adam G Kaplan, Joanne Dale, Jonathan C Routh, Michael E Lipkin, Glenn M Preminger, Kenneth Schmader, and Charles D Scales Eugene B ConeEugene B Cone More articles by this author , Brad HammillBrad Hammill More articles by this author , Adam G KaplanAdam G Kaplan More articles by this author , Joanne DaleJoanne Dale More articles by this author , Jonathan C RouthJonathan C Routh More articles by this author , Michael E LipkinMichael E Lipkin More articles by this author , Glenn M PremingerGlenn M Preminger More articles by this author , Kenneth SchmaderKenneth Schmader More articles by this author , and Charles D ScalesCharles D Scales More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2694AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary stone disease imposes a significant burden on US patients, with a prevalence of 8.8% and rising. Total annual costs likely exceed $10 billion, nearly half for inpatient care. Despite substantial inpatient expenditures for patients with urinary stone disease, little is known about these hospitalizations. Our objective was to describe resource use and costs for inpatient care of patients with urinary stone disease. METHODS We used the Nationwide Inpatient Sample (NIS), a 20% stratified sample of hospital discharges in the US. The study population included all patients discharged from 2007 to 2011 with a diagnostic code consistent with urinary stone disease. Outcomes of interest were post-discharge care (eg home health), length of stay, and cost. National estimates and comparisons of utilization and hospitalization outcomes were generated using standard weights, accounting for the complex survey design of the NIS. Costs were estimated using NIS cost-to-charge files. Multivariable regression models identified associations between costs, discharge status, and patient/hospital characteristics. RESULTS An estimated 1.85 million stone patients were discharged during the study period. The average age was 54.0 (SEM 0.13) years, and 53% were female. The overall median length of stay was 2.1 days (IQR 1, 4) with a median cost of $6300 (IQR $4000, $10,100). Older patients (≥ 65 years) represented nearly 1 in 3 of those discharged. Hospital resource use was substantially higher among these older patients: median length of stay was 3.1 days, with 25% staying more than 5.9 days. Similarly, discharge to home health (14%) or skilled nursing care (21%) was common among those over 65 years of age. Patients were more likely to be discharged to a skilled nursing facility if they were female (OR 1.20, p < 0.001) or aged greater than 65 years (OR 5.99, p < 0.001). Median estimated costs were $7700 in those ≥ 65 versus $5700 in those < 65 (p < 0.001). After controlling for gender, race, region, hospital size, ownership, and teaching status costs remained 35% higher in older adults. CONCLUSIONS Older adults utilize a substantial portion of inpatient care for stone disease, which is disproportionate to the incidence of stone disease in this group. Specifically, older adults are at high risk of longer hospital stays, additional post-discharge care, and increased costs. Investigations using more granular data are required to understand drivers of these associations, and ultimately improve outcomes for vulnerable older adults. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1172 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Eugene B Cone More articles by this author Brad Hammill More articles by this author Adam G Kaplan More articles by this author Joanne Dale More articles by this author Jonathan C Routh More articles by this author Michael E Lipkin More articles by this author Glenn M Preminger More articles by this author Kenneth Schmader More articles by this author Charles D Scales More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...