美国结石病的流行情况和治疗趋势。

Prevalence of Stone Disease and Procedure Trends in the United States.

机构信息

University of California San Diego School of Medicine, San Diego, CA.

Boston Scientific, Marlborough, MA.

出版信息

Urology. 2023 Jun;176:63-68. doi: 10.1016/j.urology.2023.03.040. Epub 2023 Apr 14.

DOI:10.1016/j.urology.2023.03.040

PMID:37062518

Abstract

OBJECTIVE

To evaluate the prevalence of stone disease and procedure trends among US commercial and Medicare populations.

METHODS

Retrospective analyses for a US commercial population and Medicare population were conducted using the Merative MarketScan Commercial Database and Medicare Standard Analytic File (5% sample), respectively. Patients aged 18+ were included if they had an encounter in any setting with a primary stone diagnosis or stone procedure (ureteroscopy [URS], percutaneous nephrolithotomy (PCNL), or shockwave lithotripsy [SWL]) between 2011 and 2019. Analyses were conducted at the patient level.

RESULTS

Over the study time horizon, the prevalence of stone disease showed a small yet statistically significant decrease in the commercial population (1.04%-1.01%; P.ß<.ß0.0001) and a statistically significant increase in the Medicare population (1.84%-2.34%; P.ß<.ß0.0001). URS.ßprocedure volumes increased by 22.6% (P.ß<.ß0.0001) in the commercial population and by 56.6% (P.ß<.ß0.0001) in the Medicare population over the study period. Similarly, PCNL.ßprocedure volumes increased by 17.4% (P.ß<.ß0.0001) in the commercial population and 27.5% (P.ß<.ß0.0001) in the Medicare population. Procedure volumes for SWL decreased by 26.9% in the commercial population (P.ß<.ß0.0001) and by 3.8% in the Medicare population although the results were not statistically significant.

CONCLUSION

The prevalence of stone disease showed a small decrease in the US commercial population and an increase in the Medicare population over the study time horizon. In both populations, increasing procedure volumes were observed for URS and PCNL while decreasing volumes were observed for SWL.

摘要

目的

评估美国商业和医疗保险人群中结石病的患病率和治疗趋势。

方法

分别使用 Merative MarketScan 商业数据库和 Medicare 标准分析文件（5%的样本）对美国商业人群和 Medicare 人群进行回顾性分析。纳入标准为 2011 年至 2019 年间在任何环境下有原发性结石诊断或结石治疗（输尿管镜检查[URS]、经皮肾镜取石术[PCNL]或体外冲击波碎石术[SWL]）的 18 岁以上患者。分析在患者层面进行。

结果

在研究期间，商业人群中结石病的患病率呈小幅度但具有统计学意义的下降（从 1.04%降至 1.01%；P.ß<.ß0.0001），而 Medicare 人群中结石病的患病率呈统计学意义的上升（从 1.84%升至 2.34%；P.ß<.ß0.0001）。URS 治疗量在商业人群中增加了 22.6%（P.ß<.ß0.0001），在 Medicare 人群中增加了 56.6%（P.ß<.ß0.0001）。同样，PCNL 治疗量在商业人群中增加了 17.4%（P.ß<.ß0.0001），在 Medicare 人群中增加了 27.5%（P.ß<.ß0.0001）。SWL 治疗量在商业人群中下降了 26.9%（P.ß<.ß0.0001），在 Medicare 人群中下降了 3.8%，但结果无统计学意义。