Burden of Unplanned Visits Post-Urinary Stone Removal
(HealthDay News) — For patients undergoing procedures to fragment or remove urinary stones, one in seven require an unplanned post-procedural visit, and these visits are associated with considerable expenditure, according to a study published in the May issue of Surgery.
Charles D. Scales Jr., MD, from the University of California in Los Angeles, and colleagues describe the frequency, variation, and financial impact of unplanned, high-acuity, follow-up visits in the treatment of patients with urinary stone disease. Data were included for 93,523 initial procedures to fragment or remove stones in privately insured patients; procedures included percutaneous nephrostolithotomy, ureteroscopy, or shock wave lithotripsy.
The researchers found that one in seven patients had an unplanned post-procedural visit, which were least common after shock wave lithotripsy (12%) and occurred with similar frequency after ureteroscopy and percutaneous nephrostolithotomy (15%). Unplanned visits were less frequent for procedures at high-volume facilities (odds ratio, 0.80; P<0.001). For unplanned visits, greater adjusted incremental expenditures per episode were seen after shock wave lithotripsy ($32,156) than ureteroscopy ($23,436).
"Patients not infrequently experience an unplanned, high-acuity visit after low-risk procedures to remove urinary stones, and the cost of these encounters is substantial," the authors write.