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Hospital cost analysis of management of patients with renal colic in the emergency department

Abstract

Acute severe colicky pain in the flank region is termed as renal colic (RC), which is commonly diagnosed and treated in the emergency department (ED). The present study is designed to investigate the hospital costs of patients with RC admitted to the ED and factors affecting the figures. Retrospective analysis includes all patients diagnosed with RC following physical examination and X-ray, ultrasound, computed tomography together with laboratory investigations in the university-based ED between February 2007 and February 2009. The study included 574 patients eligible for the predefined criteria. Mean total hospital cost in patients admitted to the ED due to RC was calculated to be 55.77 Euro. The greatest contribution to the total cost was made by radiological investigations in the ED (40.5%) followed by treatment costs (19.7%). Size and location of the stone and stay times in the ED were the independent variables affecting the costs. The costs were higher as the stones were bigger and as they were more distal in the ureter. Renal stones were associated with the lowest hospital costs. Radiological investigations are the greatest contributors in the ED costs in patients with RC. Effective measures need to be undertaken to reduce resultant costs. Preventive measures as well as diagnostic and therapeutic procedures should be standardized in the ED in accordance with technological advances and also cost-effectiveness when appropriate.

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References

  1. Perlmutter A, Miller L, Trimble LA et al (1993) Toradol, an NSAID used for renal colic, decreases renal perfusion and ureteral pressure in a canine model of unilateral ureteral obstruction. J Urol 149:926–930

    CAS  PubMed  Google Scholar 

  2. Brown J (2006) Diagnostic and treatment patterns for renal colic in US emergency departments. Int Urol Nephrol 38:87–92

    Article  CAS  PubMed  Google Scholar 

  3. Akinci M, Esen T, Tellaloglu S (1991) Urinary stone disease in Turkey: an updated epidemiological study. Eur Urol 20:200–203

    CAS  PubMed  Google Scholar 

  4. Serinken M, Karcioglu O, Turkcuer I et al (2008) Analysis of clinical and demographic characteristics of patients presenting with renal colic in the emergency department. BMC Res Notes 16:79

    Article  Google Scholar 

  5. Lotan Y, Cadeddu JA, Pearle MS (2005) International comparison of cost effectiveness of medical management strategies for nephrolithiasis. Urol Res 33:223–230

    Article  PubMed  Google Scholar 

  6. Papa L, Stiell IG, Wells GA et al (2005) Predicting intervention in renal colic patients after emergency department evaluation. CJEM 72:78–86

    Google Scholar 

  7. Prina LD, Rancatore E, Secic M et al (2002) Comparison of stone size and response to analgesic treatment in predicting outcome of patients with renal colic. Eur J Emerg Med 9:135–139

    Article  CAS  PubMed  Google Scholar 

  8. Segura JW, Preminger GM, Assimos DG et al (1997) Ureteral Stones Clinical Guidelines Panel summary report on the management of ureteral calculi. The American Urological Association. J Urol 158:1915–1921

    Article  CAS  PubMed  Google Scholar 

  9. Preminger GM, Tiselius HG, Assimos DG et al (2007) 2007 Guideline for the management of ureteral calculi. American Urological Association Education and Research, Inc; European Association of Urology. Eur Urol 52:1610–1631

    Article  PubMed  Google Scholar 

  10. Cupisti A, Pasquali E, Lusso S et al (2008) Renal colic in Pisa emergency department: epidemiology, diagnostics and treatment patterns. Intern Emerg Med 3:241–244

    Article  PubMed  Google Scholar 

  11. Pfister SA, Deckart A, Laschke S et al (2003) Unenhanced helical computed tomography vs intravenous urography in patients with acute flank pain: accuracy and economic impact in a randomized prospective trial. Eur Radiol 13:2513–2520

    Article  CAS  PubMed  Google Scholar 

  12. Greenwell TJ, Woodhams S, Denton ERM et al (2000) One year’s clinical experience with unenhanced spiral computed tomography for the assessment of acute loin pain suggestive of renal colic. BJU Int 85:632–636

    Article  CAS  PubMed  Google Scholar 

  13. Kobayashi T, Nishizawa K, Watanabe J et al (2003) Clinical characteristics of ureteral calculi detected by non-enhanced computerized tomography after unclear results of plain radiography and ultrasonography. J Urol 170:799–802

    Article  PubMed  Google Scholar 

  14. Trinchieri A (2006) Epidemiological trends in urolithiasis: impact on our health care systems. Urol Res 34:151–156

    Article  PubMed  Google Scholar 

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Correspondence to Mustafa Serinken.

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Turkcuer, I., Serinken, M., Karcioglu, O. et al. Hospital cost analysis of management of patients with renal colic in the emergency department. Urol Res 38, 29–33 (2010). https://doi.org/10.1007/s00240-009-0251-z

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  • DOI: https://doi.org/10.1007/s00240-009-0251-z

Keywords

  • Renal colic
  • Urolithiasis
  • Emergency department
  • Cost analysis
  • Hospital cost