UP-84 Impact of travel distance on clinical outcomes in patients receiving treatment for urolithiasis
Thursday June 27, 2019 from
TBD
Presenter

Danielle A Jenkins, Canada

Resident

Department of Urology

Queen's University

Abstract

Impact of travel distance on clinical outcomes in patients receiving treatment for urolithiasis

Danielle Jenkins1, Marlo Whitehead2, Gregory Hosier1, Darren T. Beiko1, Thomas McGregor1, D. Robert Siemens1.

1Department of Urology, Queen's University, Kingston, ON, Canada; 2Institute for Clinical Evaluative Sciences, Queen's University, Kingston, ON, Canada

Introduction: Treatment for urolithiasis is limited to regions with a practicing urologist and specialized centers with additional resources and expertise. Patients commonly have to travel to access these services. This study assessed the relationship between the distance traveled to receive treatment for urolithiasis and early outcomes.

Methods:  This is a population-based study of patients who received interventions for urolithiasis in Ontario between July 1, 2013 and September 30, 2017 using administrative data. Patients were stratified into three groups according to the distance travelled to receive their treatment. Descriptive statistics and the Chi-square test was used to examine differences between these groups based on the urolithiasis treatment of choice. The primary outcomes were reoperation rates and readmission rates, with secondary outcomes including emergency department visits.

Results: A total of 18,001 patients were included in the final analysis. Of these, 13,686 travelled between 0 and 30 km, 2,971 travelled between 30 and 90 km, and 1344 travelled greater than 90 km. Type of procedure and region of residence were the only covariates that appeared to have any clinically relevant association with greater distance travelled. Those who received ESWL were more likely to have travelled over 90 km (22%) compared to percutaneous nephrolithotomy (PCNL; 3%) or ureteroscopy (URS; 4%).  On univariate analysis the only association between distance travelled and any outcome was reoperation (23% for those that travelled >90km).  However, there appeared to be an interaction between distance travelled and procedure type with outcomes. No significant trends were seen when analyzing the impact of distance travelled on early outcomes for each individual procedure. 

Conclusions: This study found no clinically relevant association between the distance travelled to receive treatment for urolithiasis and early surgical outcomes.  


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