Exploring the economic landscape of ureteric stones: impact of age and gender on direct healthcare costs

• Published in: Urolithiasis Vol. 52; no. 1; p. 79
• Main Authors: Shemesh, Amit, Raz, Orit, Goldberg, Hanan, Cooper, Amir, Golomb, Dor
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 31-05-2024; Springer Nature B.V
• Subjects: Adolescent; Adult; Age; Age Factors; Aged; Costs; Emergency Service, Hospital - economics; Emergency Service, Hospital - statistics & numerical data; Female; Females; Gender; Health Care Costs - statistics & numerical data; Humans; Male; Medical Biochemistry; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Nephrology; Retrospective Studies; Sex Factors; Tomography, X-Ray Computed - economics; Ureteral Calculi - economics; Ureteral Calculi - surgery; Ureteral Calculi - therapy; Urology; Young Adult; Urolithiasis; Costs; Renal colic
• ISSN: 2194-7236; 2194-7228; 2194-7236
• DOI: 10.1007/s00240-024-01584-1

Objectives
To assess whether age or gender affects ureteric stone management costs, in patients presenting to the Emergency Department (ED) with CT proven ureteric stones.
Patients and methods
A retrospective examination was conducted on patients admitted to the ED who were diagnosed with a ureteric stone through CT scans. Data encompassing clinical, laboratory, and imaging parameters were gathered, alongside information on admissions, ED readmissions, surgical procedures, and the overall treatment cost. Comparative analyses were performed on various cost rates in relation to different stone parameters, patient clinical presentations, laboratory results, and personal histories of urolithiasis.
Results
From January 2018 to January 2020, 805 patients underwent abdominal CT scans at a single institution’s ED and were diagnosed with ureteric stones. Among them, 773 patients met the inclusion criteria, with 78% (609) being males and 22% (169) females. The mean ages for males and females were 49.4 (SD 14.4) and 51.6 (SD 15.7), respectively (
p
 = 0.08). Treatment costs exhibited a direct relationship with age, amounting to 4,025, 5,116, 6,058, and 9,225 US dollars (USD) in the 18–30, 31–50, 51–70, and over 70 age groups, respectively. Female gender was associated with higher treatment costs, averaging 6,831 USD, compared to 5,450 USD in males (
p
 = 0.03). However, there were no significant differences between genders in terms of the type of surgical procedure (
p
 = 0.4) or hospital stay duration (
p
 = 0.1).
Conclusions
Age and gender exerted a significant impact on treatment costs, revealing that advanced age and female gender were both correlated with higher direct treatment costs in the care of ureteric stones.