Economic Considerations in the Management of Nephrolithiasis

被引:44
作者
Roberson, Daniel [1 ,2 ]
Sperling, Colin [1 ,2 ]
Shah, Ankur [1 ,2 ]
Ziemba, Justin [1 ,2 ]
机构
[1] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA
[2] Univ Penn, Hosp Univ Penn, Perelman Ctr Adv Med, Div Urol,Dept Surg, 3400 Civ Ctr Blvd, Philadelphia, PA 19104 USA
关键词
Nephrolithiasis; Stone disease; Economics; Cost-effectiveness; Economic efficiency; Disposable flexible ureteroscopy; SHOCK-WAVE LITHOTRIPSY; MEDICAL EXPULSIVE THERAPY; DISTAL URETERAL CALCULI; COST-EFFECTIVENESS; KIDNEY-STONES; FLEXIBLE URETEROSCOPE; PERCUTANEOUS NEPHROLITHOTOMY; PRIMARY PREVENTION; DURABILITY; CARE;
D O I
10.1007/s11934-020-00971-6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose of Review From health systems to individuals, nephrolithiasis is economically burdensome. The aim of the current paper is to characterize the financial burden of disease associated with nephrolithiasis with an emphasis on investigating treatment modality economic efficiency. Recent Findings For small volume practices and cases where there is high risk of scope damage, disposable flexible ureteroscope utilization seems to provide economic efficiency. The rise in global prevalence of stone disease is a large contributing factor to increasing costs associated with nephrolithiasis. A large proportion of costs from kidney stones stem from ED visits and inpatient care. There are opportunities to save money by transitioning care to outpatient settings in scenarios that allow such transition. Metaphylaxis and prevention strategies are effective at lowering costs in properly selected patient populations. Flexible ureteroscopy and percutaneous nephrolithotomy (PCNL) are the most economically efficient methods of surgically treating stone disease, with PCNL being reserved for large and lower pole stones. Time off work and other indirect costs, while challenging to quantify, are important considerations in the economics of nephrolithiasis.
引用
收藏
页数:9
相关论文
共 69 条
[1]   Variables That Influence Operative Time During Percutaneous Nephrolithotomy: An Analysis of 1897 Cases [J].
Akman, Tolga ;
Binbay, Murat ;
Akcay, Muzaffer ;
Tekinarslan, Erdem ;
Kezer, Cem ;
Ozgor, Faruk ;
Seyrek, Mahir ;
Muslumanoglu, Ahmet Yaser .
JOURNAL OF ENDOUROLOGY, 2011, 25 (08) :1269-1273
[2]   Comparative medico-economic study of reusable vs. single-use flexible ureteroscopes [J].
Al-Balushi, Khalid ;
Martin, Nathalie ;
Loubon, Helene ;
Baboudjian, Michael ;
Michel, Floriane ;
Sichez, Pierre-Clement ;
Martin, Thomas ;
Di-Crocco, Eugenie ;
Gaillet, Sarah ;
Delaporte, Veronique ;
Akiki, Akram ;
Faure, Alice ;
Karsenty, Gilles ;
Lechevallier, Eric ;
Boissier, Romain .
INTERNATIONAL UROLOGY AND NEPHROLOGY, 2019, 51 (10) :1735-1741
[3]   Innovations in surgical stone disease [J].
Antonelli, Jodi A. .
CURRENT OPINION IN UROLOGY, 2016, 26 (03) :240-247
[4]   Increasing Use, Geographic Variation, and Disparities in Emergency Department CT for Suspected Urolithiasis [J].
Balthazar, Patricia ;
Sadigh, Gelareh ;
Hughes, Danny ;
Rosenkrantz, Andrew B. ;
Hanna, Tarek ;
Duszak, Richard, Jr. .
JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY, 2019, 16 (11) :1547-1553
[5]   Asymptomatic Nephrolithiasis Detected by Ultrasound [J].
Bansal, Amar D. ;
Hui, Jennifer ;
Goldfarb, David S. .
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2009, 4 (03) :680-684
[6]   Cost-effectiveness of medical expulsive therapy using alpha-blockers for the treatment of distal ureteral stones [J].
Bensalah, Karim ;
Pearle, Margaret ;
Lotan, Yair .
EUROPEAN UROLOGY, 2008, 53 (02) :411-419
[7]  
Bierkens AF, 1998, BRIT J UROL, V81, P31
[8]   Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria [J].
Borghi, L ;
Schianchi, T ;
Meschi, T ;
Guerra, A ;
Allegri, F ;
Maggiore, U ;
Novarini, A .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (02) :77-84
[9]   Prevalence of Urolithiasis in Asymptomatic Adults: Objective Determination Using Low Dose Noncontrast Computerized Tomography [J].
Boyce, Cody J. ;
Pickhardt, Perry J. ;
Lawrence, Edward M. ;
Kim, David H. ;
Bruce, Richard J. .
JOURNAL OF UROLOGY, 2010, 183 (03) :1017-1021
[10]   Frequency of Ureteroscope damage seen at a tertiary care center [J].
Carey, Robert I. ;
Gomez, Christopher S. ;
Maurici, Giuseppe ;
Lynne, Charles M. ;
Leveillee, Raymond J. ;
Bird, Vincent G. .
JOURNAL OF UROLOGY, 2006, 176 (02) :607-610