Brian C Sninsky1, Stephen Y Nakada2, Kristina L Penniston3. 1. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI. 2. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. 3. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address: penn@urology.wisc.edu.
Abstract
OBJECTIVE: To examine the association of age, gender, and socioeconomic status with appointment attendance and completion of 24-hour urine collections to identify patient characteristics associated with barriers to treatment. METHODS: A retrospective review was performed under institutional review board approval for new patients scheduled at a single metabolic stone clinic over a 1.5-year period. Postal codes were used to identify poverty and education levels using US Census Bureau data. We evaluated 3 years of adherence based on "no shows," percentage of stone clinic appointments attended, and percentage of 24-hour urine collections completed. Quintile analyses were used to further explore nonlinear data. RESULTS: A total of 447 patients were included (246 men and 201 women). Mean age was 49 ± 14.5 years. Younger age, areas of higher poverty, and areas of lower education were all weakly to moderately associated with increased "no show" rates and decreased clinic attendance. Men tended to not show for appointments more frequently than women (P = .043). When grouped by age groups, younger age was strongly correlated with decreased 24-hour urine collection completion (R = 0.75). When divided into age quintiles, relationships between "no shows" and clinic attendance were strengthened as they were when patients were divided into poverty quintiles. CONCLUSION: It is critical for providers to be aware of health disparities in medical stone management. Low education, high poverty, and younger age are associated with suboptimal evaluation follow-up. Of note, the lowest adherence was in younger patients, a population that requires the most urgent workup.
OBJECTIVE: To examine the association of age, gender, and socioeconomic status with appointment attendance and completion of 24-hour urine collections to identify patient characteristics associated with barriers to treatment. METHODS: A retrospective review was performed under institutional review board approval for new patients scheduled at a single metabolic stone clinic over a 1.5-year period. Postal codes were used to identify poverty and education levels using US Census Bureau data. We evaluated 3 years of adherence based on "no shows," percentage of stone clinic appointments attended, and percentage of 24-hour urine collections completed. Quintile analyses were used to further explore nonlinear data. RESULTS: A total of 447 patients were included (246 men and 201 women). Mean age was 49 ± 14.5 years. Younger age, areas of higher poverty, and areas of lower education were all weakly to moderately associated with increased "no show" rates and decreased clinic attendance. Men tended to not show for appointments more frequently than women (P = .043). When grouped by age groups, younger age was strongly correlated with decreased 24-hour urine collection completion (R = 0.75). When divided into age quintiles, relationships between "no shows" and clinic attendance were strengthened as they were when patients were divided into poverty quintiles. CONCLUSION: It is critical for providers to be aware of health disparities in medical stone management. Low education, high poverty, and younger age are associated with suboptimal evaluation follow-up. Of note, the lowest adherence was in younger patients, a population that requires the most urgent workup.
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