Outcomes of Sacral Neuromodulation in a Privately Insured Population.

Objective: In this study, we analyzed claims data from the Ingenix data base to analyze outcomes of sacral neuromodulation with respect to both provider and patient factors.

Materials And Methods: We used the Ingenix (I3) data base to determine demographic, diagnosis, and procedure success information for years 2002-2007 for privately insured patients. Demographic information was obtained, as were the diagnoses given and procedures performed, based on ICD-9 diagnosis codes and Current Procedural Terminology procedure codes.

Use of and regional variation in initial CT imaging for kidney stones.

Objective: We sought to determine the prevalence of initial computed tomography (CT) utilization and to identify regions in the United States where CT is highly used as the first imaging study for children with nephrolithiasis.

Methods: We performed a cross-sectional study in 9228 commercially insured children aged 1 to 17 years with nephrolithiasis who underwent diagnostic imaging in the United States between 2003 and 2011. Data were obtained from MarketScan, a commercial insurance claims database of 17,827,229 children in all 50 states.

Daily mean temperature and clinical kidney stone presentation in five U.S. metropolitan areas: a time-series analysis.

Background: High ambient temperatures are a risk factor for nephrolithiasis, but the precise relationship between temperature and kidney stone presentation is unknown.

Objectives: Our objective was to estimate associations between mean daily temperature and kidney stone presentation according to lag time and temperatures.

Methods: Using a time-series design and distributed lag nonlinear models, we estimated the relative risk (RR) of kidney stone presentation associated with mean daily temperatures, including cumulative RR for a 20-day period, and RR for individual daily lags through 20 days.

Predictors of implantable pulse generator placement after sacral neuromodulation: who does better?

Objectives: Numerous studies have documented a relationship between provider variables, including surgeon volume and specialty, and outcomes for surgical procedures. In this study we analyzed claims data from a Medicare database to analyze outcomes of sacral neuromodulation (SNM) with respect to both provider and patient factors.

Materials And Methods: A 5% random sample of Medicare beneficiaries from 1997 to 2007 was the data source.

The effect of sacral neuromodulation on anticholinergic use and expenditures in a privately insured population.

Objectives: Sacral neuromodulation is Food and Drug Administration approved for many types of voiding dysfunction. Goals of treatment often include cessation of anticholinergic therapy. With the goal of understanding the impact of sacral neuromodulation on anticholinergic use, we analyzed patterns of care using a national claims-based dataset.

Battery explantation after sacral neuromodulation in the Medicare population.

Aims: To determine sacral neuromodulation battery life and the patient and provider risk factors for early explantation in a population-based sample.

Methods: A 5% sample of Medicare beneficiaries from 1997 to 2007 served as the data source. All patients who had a sacral neuromodulation device implanted in that time period were included.

National trends in the usage and success of sacral nerve test stimulation.

Purpose: Little is known about outcomes of sacral neuromodulation in the general community, with published reports to date limited to case series or randomized, controlled trials. The goal of this analysis was to identify the national sacral neuromodulation test phase success rate and patient factors that contribute to success.

Materials And Methods: Medical claims data were obtained from a 5% sample of Medicare beneficiaries (1997 to 2007) and from employees of 25 large (Fortune 500) companies (Ingenix®, 2002 to 2007).

Use of radical cystectomy for patients with invasive bladder cancer.

Background: Evidence-based guidelines recommend radical cystectomy for patients with muscle-invasive bladder cancer. However, many patients receive alternate therapies, such as chemotherapy or radiation. We examined factors that are associated with the use of radical cystectomy for invasive bladder cancer and compared the survival outcomes of patients with invasive bladder cancer by the treatment they received.

Quality of surveillance for stage I testis cancer in the community.

Purpose: Patients with clinical stage I testicular germ cell tumors have been managed with adjuvant radiotherapy, chemotherapy, or retroperitoneal lymph node dissection (RPLND). The use of surveillance-only strategies at referral centers has yielded survival outcomes comparable to those achieved with adjuvant therapy. We evaluated compliance with follow-up protocols developed at referral centers within the community.

Trends in the use of gross and frozen section pathological consultations during partial or radical nephrectomy for renal cell carcinoma.

Purpose: There is no consensus regarding the role of intraoperative pathological consultation during kidney cancer surgery. Accordingly intraoperative pathological consultation use is susceptible to variation based on nonclinical factors. We explored this hypothesis by evaluating national trends in the use of intraoperative pathological consultation during radical or partial nephrectomy with time, across regions, and by patient and provider characteristics.

Increasing costs of urinary incontinence among female Medicare beneficiaries.

Purpose: We measured the financial burden of urinary incontinence in the United States from 1992 to 1998 among women 65 years old or older.

Materials And Methods: We analyzed Medicare claims for 1992, 1995 and 1998 and estimated spending on the treatment of urinary incontinence. Total costs were stratified by type of service (inpatient, outpatient and emergency department).

Urologic diseases in America Project: analytical methods and principal findings.

Purpose: The burden of urological diseases on the American public is immense in human and financial terms but it has been under studied. We undertook a project, Urologic Diseases in America, to quantify the burden of urological diseases on the American public.

Materials And Methods: We identified public and private data sources that contain population based data on resource utilization by patients with benign and malignant urological conditions.