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• W2329470886 abstract "You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness III1 Apr 2012413 INPATIENT UROLOGIC CARE IN CRITICAL ACCESS HOSPITALS Adam J. Gadzinski, Justin B. Dimick, Zaojun Ye, and David C. Miller Adam J. GadzinskiAdam J. Gadzinski Ann Arbor, MI More articles by this author , Justin B. DimickJustin B. Dimick Ann Arbor, MI More articles by this author , Zaojun YeZaojun Ye Ann Arbor, MI More articles by this author , and David C. MillerDavid C. Miller Ann Arbor, MI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.479AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Critical Access Hospitals (CAHs) comprise over 25% of acute care hospitals in the United States. As evidenced by their unique cost-based reimbursement, policymakers view CAHs as essential healthcare providers for rural communities and other underserved populations. In order to better understand their role in urologic care delivery, we examined utilization patterns for inpatient urological procedures at CAHs and non-CAH hospitals. METHODS We used data from the American Hospital Association (AHA) survey to identify all CAHs in the United States. After linking AHA data with the Nationwide Inpatient Sample (NIS), we used Clinical Classification Software to identify all patients who underwent at least one urological procedure during an inpatient stay at a CAH or non-CAH hospital. We classified each procedure as major (i.e., requiring an operating room) or minor, and assigned it to one of seven clinical categories (Figure). We then examined and compared the type and distribution of urological procedures performed at CAH versus non-CAH centers. RESULTS Among the 1,292 CAHs and 3,760 non-CAHs reporting data to the AHA, 35% and 36%, respectively, had at least one year of data in the NIS. From 2005 through 2009, these centers performed 1,013,762 urological procedures (49% major) during 702,116 admissions. CAHs performed only 1% of all procedures. Additionally, the proportion of CAHs performing any (65%) or major urological procedures (55%) was significantly lower than for non-CAH facilities (98% and 96%, respectively, both p-values<0.01). The distribution of both minor and major procedures also differed for CAH vs non-CAH centers (p<0.01). For major procedures, urologic cancer surgery is comparatively rare at CAHs (Figure). Instead, anti-incontinence surgeries represent the most common major inpatient urological procedures. CONCLUSIONS Two-thirds of CAHs perform inpatient urological procedures; however, only half provide access to major urologic surgery. The profile of major procedures is also different than for non-CAH facilities, with a greater emphasis on treatment of urinary incontinence and other benign urological conditions. These data inform ongoing efforts to enhance access and quality of urological care for rural communities and other underserved populations. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e169 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adam J. Gadzinski Ann Arbor, MI More articles by this author Justin B. Dimick Ann Arbor, MI More articles by this author Zaojun Ye Ann Arbor, MI More articles by this author David C. Miller Ann Arbor, MI More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2329470886 date "2012-04-01" @default.
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• W2329470886 title "413 INPATIENT UROLOGIC CARE IN CRITICAL ACCESS HOSPITALS" @default.
• W2329470886 doi "https://doi.org/10.1016/j.juro.2012.02.479" @default.
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