Skip to main content
Journal cover image

Quality of Acute Care for Patients With Urinary Stones in the United States.

Publication ,  Journal Article
Scales, CD; Bergman, J; Carter, S; Jack, G; Saigal, CS; Litwin, MS; NIDDK Urologic Diseases in America Project,
Published in: Urology
November 2015

OBJECTIVE: To describe guideline adherence for patients with suspected upper tract stones. PATIENTS AND METHODS: We performed a cross-sectional analysis of visits recorded by the National Hospital Ambulatory Medical Care Survey (emergency department [ED] component) in 2007-2010 (most recent data). We assessed adherence to clinical guidelines for diagnostic laboratory testing, imaging, and pharmacologic therapy. Multivariable regression models controlled for important covariates. RESULTS: An estimated 4,956,444 ED visits for patients with suspected kidney stones occurred during the study period. Guideline adherence was highest for diagnostic imaging, with 3,122,229 (63%) visits providing optimal imaging. Complete guideline-based laboratory testing occurred in only 2 of every 5 visits. Pharmacologic therapy to facilitate stone passage was prescribed during only 17% of eligible visits. In multivariable analysis of guideline adherence, we found little variation by patient, provider, or facility characteristics. CONCLUSION: Guideline-recommended care was absent from a substantial proportion of acute care visits for patients with suspected kidney stones. These failures of care delivery likely increase costs and temporary disability. Targeted interventions to improve guideline adherence should be designed and evaluated to improve care for patients with symptomatic kidney stones.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

November 2015

Volume

86

Issue

5

Start / End Page

914 / 921

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Calculi
  • United States
  • Sex Factors
  • Risk Assessment
  • Quality of Health Care
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Scales, C. D., Bergman, J., Carter, S., Jack, G., Saigal, C. S., Litwin, M. S., & NIDDK Urologic Diseases in America Project, . (2015). Quality of Acute Care for Patients With Urinary Stones in the United States. Urology, 86(5), 914–921. https://doi.org/10.1016/j.urology.2015.07.040
Scales, Charles D., Jonathan Bergman, Stacey Carter, Gregory Jack, Christopher S. Saigal, Mark S. Litwin, and Mark S. NIDDK Urologic Diseases in America Project. “Quality of Acute Care for Patients With Urinary Stones in the United States.Urology 86, no. 5 (November 2015): 914–21. https://doi.org/10.1016/j.urology.2015.07.040.
Scales CD, Bergman J, Carter S, Jack G, Saigal CS, Litwin MS, et al. Quality of Acute Care for Patients With Urinary Stones in the United States. Urology. 2015 Nov;86(5):914–21.
Scales, Charles D., et al. “Quality of Acute Care for Patients With Urinary Stones in the United States.Urology, vol. 86, no. 5, Nov. 2015, pp. 914–21. Pubmed, doi:10.1016/j.urology.2015.07.040.
Scales CD, Bergman J, Carter S, Jack G, Saigal CS, Litwin MS, NIDDK Urologic Diseases in America Project. Quality of Acute Care for Patients With Urinary Stones in the United States. Urology. 2015 Nov;86(5):914–921.
Journal cover image

Published In

Urology

DOI

EISSN

1527-9995

Publication Date

November 2015

Volume

86

Issue

5

Start / End Page

914 / 921

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Calculi
  • United States
  • Sex Factors
  • Risk Assessment
  • Quality of Health Care
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Logistic Models