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Integrated Care in a Large Public System Improves Simple Kidney Stone Management.

Cecilia Wada¹, Aaron A Laviana², Tarah Woodle²

¹The David Geffen School of Medicine at UCLA, Los Angeles, California.

Urology Practice

|October 25, 2024

Summary

This summary is machine-generated.

Clinical integration significantly reduces kidney stone treatment costs and patient steps. This approach enhances care efficiency and value for patients and providers within large health systems.

Keywords:

costs and cost analysis health care disparities health care quality, access, and evaluation kidney calculi workforce

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Area of Science:

Health Services Research
Health Economics
Urology

Background:

The Los Angeles County Department of Health Services, a major public health system, utilizes clinical integration for collaborative specialty care.
Comparing integrated and traditional care models is crucial for understanding efficiency and cost-effectiveness in managing kidney stones.

Purpose of the Study:

To compare the patient burden and cost of kidney stone diagnosis, workup, and management between integrated and non-integrated care pathways.
To evaluate the impact of clinical integration on the efficiency and cost of kidney stone care.

Main Methods:

Employed time-driven activity-based costing to analyze costs associated with kidney stone care.
Conducted interviews and observations to map workflows and identify resource requirements in both integrated and traditional models.
Calculated the total cost per stone episode and the number of steps to surgical scheduling.

Main Results:

The integrated pathway cost $499.04 per stone episode, versus $699.81 in the non-integrated pathway, a 29% cost reduction.
Integrated care required 11 steps to operating room scheduling, compared to 14 steps in the traditional pathway.
Demonstrated significant improvements in efficiency and cost reduction through clinical integration.

Conclusions:

Clinical integration offers a more efficient and cost-effective model for kidney stone care from patient, provider, and health system viewpoints.
Integrated care has the potential to improve access to specialty services, enhance care value, and lessen the patient treatment burden.