WCE 2018: Contemporary Trends in Percutaneous Nephrolithotomy Across New York State: A Review of the Statewide Planning and Research Cooperative System

Paris, France (UroToday.com) Percutaneous Nephrolithotomy (PCNL) is the gold standard of treatment for patients with renal stones larger that two centimeters, or with lower pole renal stones greater that one centimeter. When attempting to assess the rates of PCNL across the United States, there is limited data describing the effect socioeconomic factors have on the rate of PCNL and how these factors play a role in a patients’ accessibility to care. 

In light of these facts, Dr. Patel and colleagues at the New York Medical College conducted a retrospective review of all hospital discharges for PCNL using the New York Statewide Planning and Research Cooperative System (SPARCS) database from 2006-2014. At each institution, general patient demographics and overall PCNL case volume were collected. Institutions were then characterized as high, medium, or low volume PCNL centers. 

Dr. Patel found that between 2006 and 2014, the number of PCNL performed throughout the state of New York increased, peaking in 2012. They found that the highest increase in PCNL cases occurred at high volume centers (>170% increase). Notably, they found that low volume PCNL centers mainly provided care to minority patients and patients with Medicaid. Furthermore, high volume centers provided care mostly to patients with private insurance and boasted a lower length of postoperative hospital stay when compared to low volume institutions. Dr. Patel indicated that these findings evince a widening disparity in access to healthcare and the quality of the care attainable.

Across the state of New York, Dr. Patel and colleagues noted a regionalization of care along with socioeconomic factors that pose a barrier to care for minorities in particular regions across the state. Dr. Patel stated that more facts need to be obtained in order to combat the widening healthcare disparity. 

Presented by: Neel Patel, MD - New York Medical College 

Authors: N. Patel, S. Parikh, F. Guo, J. Bloom, A. Schulman, S. Fullerton, J. Phillips, M. Choudhury, M. Eshghi - New York Medical College 

Written by: Mitchell O’Leary , Department of Urology, University of California-Irvine, medical writer for UroToday.com. at the 36th World Congress of Endourology (WCE) and SWL - September 20-23, 2018 Paris, France