Urologic diseases in America project: Urolithiasis
Urologic diseases in America project: Urolithiasis
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DOI：
10.1097/01.ju.0000152082.14384.d7
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发表时间：
2005-03-01
影响因子：
6.6
通讯作者：
Curhan, GC
中科院分区：
文献类型：
--
作者：
Pearle, MS;Calhoun, EA;Curhan, GC
目的：我们通过确定卫生保健资源的使用趋势和估计疾病的经济影响来量化美国尿石症的负担。材料和方法：用于产生这些结果的分析方法已经在前面描述过。结果：全国因诊断为尿石症而住院治疗的比率下降了15%而住院日数则由一九九四年的2.6天减至二〇年的2.2天。1992年至1998年期间，医疗保险受益人的住院率高出2.5至3倍，变化不大。2000年记录了约200万次初步诊断为尿石症的门诊就诊。1994年至2000年期间，医院门诊就诊人数增加了40%，1992年至2000年期间，医生办公室就诊人数增加了43%。1992年至1998年期间，在医疗保险人口中，医院门诊和办公室就诊分别增加了29%和41%。在整个1990年代，外科手术的分布保持相对稳定。冲击波碎石术是最常用的手术，其次是输尿管镜检查。总体而言，2000年因诊断为尿石症而提出索赔的个人估计年度总支出接近21亿美元，自1994年以来增长了50%。尿石症的费用估计每年近20亿美元，尽管住院治疗转向门诊治疗和微创治疗方式的出现，也许是因为结石病的流行率在增加。
Purpose: We quantified the burden of urolithiasis in the United States by identifying trends in the use of health care resources and estimating the economic impact of the disease.Materials and Methods: The analytical methods used to generate these results have been described previously.Results: The rate of national inpatient hospitalizations for a diagnosis of urolithiasis decreased by 15% and hospital length of stay decreased from 2.6 to 2.2 days between 1994 and 2000. Rates of hospitalization were 2.5 to 3-fold higher for Medicare beneficiaries with little change between 1992 and 1998. Almost 2 million outpatient visits for a primary diagnosis of urolithiasis were recorded in 2000. Hospital outpatient visits increased by 40% between 1994 and 2000 and physician office visits increased by 43% between 1992 and 2000. In the Medicare population hospital outpatient and office visits increased by 29% and 41%, respectively, between 1992 and 1998. The distribution of surgical procedures remained relatively stable through the 1990s. Shock wave lithotripsy was the most commonly performed procedure, followed closely by ureteroscopy. Overall the total estimated annual expenditure for individuals with claims for a diagnosis of urolithiasis was almost $2.1 billion in 2000, representing a 50% increase since 1994.Conclusions: The cost of urolithiasis is estimated at almost $2 billion annually and it appears to be increasing with time despite a shift in inpatient to outpatient treatment and the emergence of minimally invasive treatment modalities, perhaps because the prevalence of stone disease is increasing.