Login to Access Video or Poster Abstract: MP95-05
Sources of Funding: Departmental

Introduction

Urinary stone disease (USD) has long been considered a condition afflicting those of working age. As the US population ages, however, it is unclear what impact changing population dynamics may have on care utilization. The objective of our research was to examine trends in health care utilization for USD in the United States by age, with a particular emphasis on older adults.

Methods

We used data from the Nationwide Inpatient Sample (NIS) and the Nationwide Emergency Department Sample (NEDS) to estimate trends for inpatient and emergency department care utilization from 2006 to 2013. Older adults were defined as individuals aged at least 65 years. Encounters for USD were identified using diagnostic codes and established algorithms. We calculated annual number of ED visits and hospitalizations for stones by age group. Linear regression was used to assess changes in utilization over time.

Results

An estimated 1.77 million ED visits and 1 million inpatient discharges for USD occurred during the study period for older adults (≥65 years). ED visits with principal diagnosis of USD increased 66% (p <.001) for ages 65-84 and 72% (p <.001) for ages 85+, whereas younger adults (ages 18-64 years) only increased 19% (p <.001) (Figure). Similar trends were observed for inpatient discharges, with an increase of 15% (p = .0014) for ages 65-84 and 34% (p = .0049) for ages 85+. Inpatient discharges for younger adults decreased during the study period. In sensitivity analyses examining any diagnosis of USD, similar increases in utilization by older adults were noted.

Conclusions

Health care utilization for USD is growing rapidly among older adults, and faster than any other age group. Further research is required to determine the extent to which this trend reflects changing population dynamics, changing risk of stones among older individuals, or both. Regardless of the underlying causes, it will be imperative to develop approaches for medical and surgical stone care for these older and often frail adults.

Funding

Departmental