PD08-06 STATEWIDE HEALTHCARE UTILIZATION BY SPINA BIFIDA PATIENTS WITH UROLITHIASIS IN CALIFORNIA

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes I (PD08)1 May 2024PD08-06 STATEWIDE HEALTHCARE UTILIZATION BY SPINA BIFIDA PATIENTS WITH UROLITHIASIS IN CALIFORNIA Nathan VanderVeer-Harris, Yi Li, Debbie Goldberg, Adrian Fernandez, Elaine Allen, Rory Grant, Lindsay Hampson, and Hillary Copp Nathan VanderVeer-HarrisNathan VanderVeer-Harris , Yi LiYi Li , Debbie GoldbergDebbie Goldberg , Adrian FernandezAdrian Fernandez , Elaine AllenElaine Allen , Rory GrantRory Grant , Lindsay HampsonLindsay Hampson , and Hillary CoppHillary Copp View All Author Informationhttps://doi.org/10.1097/01.JU.0001008576.33217.96.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Spina bifida (SB) patients are at higher risk of urinary stone disease due to treatment related sequalae like bladder augmentation and innate physiological changes of urinary-neurological dysfunction. We propose that SB patients with concurrent stone disease are at an increased risk of significant healthcare utilization. We aimed to capture the impact of these compounding factors on inpatient encounters using a large, statewide database. METHODS: We performed a secondary analysis of California's Department of Health Care Access and Information (HCAI) database, which captures all patients in the state who are admitted to the hospital, from 2005 to 2017. We compared healthcare utilization across three groups: SB patients with urolithiasis (SB-Stone), SB patients without urolithiasis (SB-Control), and urolithiasis patients without SB (Stone-Control). The primary outcome was the mean number of inpatient encounters per patient. Secondary outcomes included the mean length of stay (LOS) per inpatient hospital encounter and the mean cumulative cost per inpatient hospital encounter. Chi-Squared, Students t-test and ANOVA were employed. A p-value of 0.01 determined statistical significance. RESULTS: There were 1,876 SB-Stone, 18,419 SB-Control, and 1,034,681 Stone-Control patients included (Table 1). The mean number of inpatient encounters was 9.9 (± 15.0) for SB-Stone, 4.9 (± 7.7) for SB-Control, and 4.2 (± 6.7) for Stone-Control (p<0.01). The SB-Stone patients had the greatest mean cumulative cost among all inpatient encounters at $702K (± $1.2M) per patient, followed by SB-Control at $331K (± $729K) and Stone-Control at $253K (± $618K) (p<0.01). The mean cost per inpatient stone-specific diagnosis encounter was $74K (± $119K) for SB-Stone and $56K (± $156K) for Stone-Control (p<0.01). The mean LOS for stone-specific encounters was 7.9 days (± 44.8) for SB-Stone and 5.1 days (± 28.3) for Stone-Control (p=0.03). CONCLUSIONS: We found that SB-Stone patients have a significantly larger number of inpatient encounters in the healthcare system, which are lengthier and more costly. These findings show that urolithiasis increases healthcare utilization in an already high-utilization group, and efforts to implement preventative care to address stone disease by healthcare providers and payers are important. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e175 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nathan VanderVeer-Harris More articles by this author Yi Li More articles by this author Debbie Goldberg More articles by this author Adrian Fernandez More articles by this author Elaine Allen More articles by this author Rory Grant More articles by this author Lindsay Hampson More articles by this author Hillary Copp More articles by this author Expand All Advertisement PDF downloadLoading ...