Incremental Healthcare Cost Implications of Retreatment Following Ureteroscopy or Percutaneous Nephrolithotomy for Upper Urinary Tract Stones: A Population-Based Study of Commercially-Insured US Adults

Purpose: This study describes the incremental healthcare costs associated with retreatment among adults undergoing ureteroscopy (URS) or percutaneous nephrolithotomy (PCNL) for upper urinary tract stones (UUTS). Patients and Methods: The IBM[R] MarketScan[R] Commercial Database was used to identify...

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Bibliographic Details
Published in:Medical devices (Auckland, N.Z.) N.Z.), 2022-01, Vol.15, p.371-384
Main Authors: Johnston, Stephen S, Chen, Brian Po-Han, Rai, Pragya, Grange, Philippe, Dwarakanathan, Harikumaran R, Amos, Tony, Johnson, Barbara H, Ghosh, Sudip K, Buchholz, Noor
Format: Article
Language:English
Subjects:
Adults
Comorbidity
Computer industry
Demographics
economic analysis
Economic aspects
follow-up
Generalized linear models
Health care expenditures
Hospitals
kidney stone
Kidney stones
Lithotripsy
Medical care, Cost of
Original Research
Patients
Pharmaceutical industry
Population
Population-based studies
post-procedure
Ureteroscopy
Urogenital system
urolithiasis
Urological surgery
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Summary:Purpose: This study describes the incremental healthcare costs associated with retreatment among adults undergoing ureteroscopy (URS) or percutaneous nephrolithotomy (PCNL) for upper urinary tract stones (UUTS). Patients and Methods: The IBM[R] MarketScan[R] Commercial Database was used to identify adults aged 18-64 years with UUTS treated with URS or PCNL between January 2010 and December 2019. Patients had 12 months of continuous insurance coverage before (baseline) and after (follow-up) the first (index) procedure. The primary outcome was total all-cause healthcare costs measured over the 365-day follow-up period, not inclusive of index costs. Generalized linear models were used to estimate the incremental costs associated with retreatment within 90 (early) or 91-365 days post-index (later) relative no retreatment. The models adjusted for demographics, comorbidities, stone(s) location, treatment setting, procedural characteristics (eg, 1-step vs 2-step PCNL) and index year. Results: Approximately 23% (27,402/119,800) of URS patients were retreated (82% had early retreatments). The adjusted mean total cost was $10,478 (95% CI: $10,281-$10,675) for patients with no retreatment, $25,476 (95% CI: $24,947-$26,004) for early retreatment ($14,998 incremental increase, p
ISSN:1179-1470
1179-1470
DOI:10.2147/MDER.S384823