The following is a summary of “Underinsurance And Multiple Surgical Treatments for Kidney Stones,” published in the FEBRUARY 2023 issue of Urology by Bayne, et al.
For a study, researchers sought to investigate the association between low socioeconomic status (SES) and the need for multiple surgeries within one year for larger, more complex stones. Specifically, the study aimed to determine if underinsurance (including Medicaid, Medicare, and self-pay insurance types) predicts multiple surgical interventions.
The retrospective longitudinal study utilized prospectively collected data from the California Department of Health Care Access and Information (HCAI) dataset. The study included adult patients who underwent at least one urologic stone procedure and had their first recorded kidney stone encounter between 2009 and 2018. The patients were followed for one year after their initial surgery to assess for factors predicting multiple surgical treatments for stones.
A total of 156,319 adult patients were included in the study. The proportion of individuals in private insurance, Medicaid, Medicare, and self-pay/indigent groups differed by the presence or absence of additional surgeries (64.0%, 13.5%, 19.4%, and 0.1%, vs 70.3%, 10.1%, 16.6%, and 0.1%, respectively). The odds of undergoing multiple surgeries were significantly higher for Medicaid (1.46 [1.40-1.53] P < .001) and Medicare (1.15 [1.10-1.20] P < .001) insurance types when compared to private insurance. There was no significant association between the self-pay/indigent insurance type and the need for multiple surgeries (1.35 [0.83-2.19], P = 1.0).
The study found that underinsured adult patients were more likely to require a second surgery for kidney stones within one year of the initial surgical treatment. The study added to the growing evidence linking suboptimal healthcare access and disparate outcomes for kidney stone patients.