Urinary Calculi Care Pathways in a French Nationwide Study: The Costs, Lithiasis and Pathways (CLiPs) Study

Area of Science:

• Urology
• Health Economics
• Medical Data Analysis

Background:

• Urinary stone treatment involves competing technical approaches, high incidence, and recurrence rates, making it a significant health-economic concern.
• French healthcare funding reforms (Tarification A l'Activité - T2A) have raised concerns about potential overactivity in urinary stone treatment.
• The study investigates reintervention rates in urinary stone treatment within the context of French healthcare economics.

Purpose of the Study:

• To describe key parameters in urinary stone treatment, focusing on reintervention rates.
• To analyze patient stays and procedures in a nationwide private clinic database.
• To evaluate the frequency of repeated interventions for urinary stones.

Main Methods:

• Utilized a linked database of patient stays from a nationwide private clinic group.
• Analyzed data from 31,209 patients identified in 2020, covering procedures and stays from 2019-2021.
• Collected demographic data, number of stays, interventions, ureteral stentings, and outpatient stay rates.

Main Results:

• Analyzed 50,295 stays from 31,209 patients (median age 54 years, 1.6 average stays per patient).
• Ureteroscopy (URS) was the most common procedure (63.3%), followed by Shockwave Lithotripsy (SWL) (24.7%).
• Repeat procedures after initial URS were observed in 3.2% (SWL) and 24.2% (URS), with an average of 1.3 additional procedures.

Conclusions:

• Despite study limitations, the frequency of repeated urinary stone procedures was lower than initially expected.
• Findings provide valuable data for health-economic assessments of urinary stone treatment strategies in France.
• The study contributes to understanding treatment patterns and resource utilization in managing urinary stones.