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Comorbid Urolithiasis Significantly Increases Utilization Across Healthcare Settings for Individuals With Spina
Nathan VanderVeer-Harris1, Yi Li2, Adrian M Fernandez2
1Department of Urology, Tulane University School of Medicine, New Orleans, LA.
Urology
|May 29, 2025
Summary
Urolithiasis significantly increases healthcare utilization in spina bifida patients, leading to more encounters and higher costs. Comorbidities further amplify this increased risk for spina bifida patients with urolithiasis.
Area of Science:
- Urology
- Healthcare Utilization
- Spina Bifida Research
Background:
- Spina bifida (SB) is a complex congenital condition often associated with genitourinary complications.
- Urolithiasis (urinary tract stones) is a known comorbidity in SB patients.
- Understanding the impact of urolithiasis on healthcare utilization in SB is crucial for resource allocation and patient management.
Purpose of the Study:
- To quantify the impact of comorbid urolithiasis on healthcare utilization among spina bifida patients.
- To compare healthcare encounter frequency, charges, and length of stay between SB patients with and without urolithiasis.
Main Methods:
- Secondary analysis of California healthcare data (2005-2017).
- Comparison of spina bifida patients with urolithiasis (SB-Stone) versus without (SB-Control).
- Primary outcome: mean healthcare encounters (inpatient, ED, ambulatory surgery); secondary outcomes: charges and length of stay.
Main Results:
- SB-Stone patients had significantly more healthcare encounters (35.4 vs 15.6, P <.001) across all settings.
- SB-Stone patients experienced increased inpatient charges and length of stay (P <.001).
- Urolithiasis independently increased the odds of high healthcare utilization (9+ encounters; OR 2.47).
Conclusions:
- Urolithiasis disproportionately elevates healthcare utilization in spina bifida patients.
- Increased comorbidity in SB-Stone patients is linked to higher encounter rates, exacerbating healthcare burden.
- These findings highlight the vulnerability of SB patients with urolithiasis regarding healthcare resource demands.
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