Taking the Procedure to the Patient: Increasing Access to Urological Procedural Care through Outreach

Matthew A Uhlman; Thomas S Gruca; Craig A Jarvie; George M Ghareeb; Paul G Morrison; Yu Han; Kenneth G Nepple; Bradley A Erickson

doi:10.1016/j.urpr.2016.07.006

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Taking the Procedure to the Patient: Increasing Access to Urological Procedural Care through Outreach

Journal article

Open access

Taking the Procedure to the Patient: Increasing Access to Urological Procedural Care through Outreach

Matthew A Uhlman, Thomas S Gruca, Craig A Jarvie, George M Ghareeb, Paul G Morrison, Yu Han, Kenneth G Nepple and Bradley A Erickson

Urology Practice, Vol.4(4), pp.335-341

07/2017

DOI: 10.1016/j.urpr.2016.07.006

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Abstract

We previously showed that urological outreach clinics significantly increase access to urological clinical care in rural populations. How such clinics affect access to urological procedural care is unknown. In this study we analyzed the use of outreach facilities for outpatient hospital based urological procedural care in a rural state. Using information from the Office of Statewide Clinical Education Programs and the Iowa Hospital Association database, we analyzed provider level data in Iowa from 2010 to 2013. Based on CPT codes all outpatient urological procedural care was categorized by procedure type and intent. Cities containing an Iowa Hospital Association hospital were characterized as primary vs outreach. Geographic data were used for analysis of travel metrics and proximity to urological procedural care sites. Outreach urological procedures were then compared to urological procedural care at primary centers. During the study period 11,464 outreach urological procedures were performed, accounting for 15.0% of all outpatient urological procedures in the state. The yearly number of outreach procedures remained relatively stable during the study period. The majority (51.7%) of outreach urological procedures were therapeutic and endoscopic (62.9%) in nature. Extracorporeal shock wave lithotripsy was significantly more common for treating stone disease in the outreach setting compared to ureteroscopy (p <0.0001). A large percentage of the total urological procedural care in our state was done at outreach clinics and, while the majority was of low acuity, it was therapeutic. Changes in health care are projected to affect rural hospitals, which rely heavily on procedural care, and this study is the first to our knowledge to demonstrate the role that urological procedural care can have in such locations.

Urology

rural health services

community-institutional relations

health services accessibility

Details

Title: Subtitle: Taking the Procedure to the Patient: Increasing Access to Urological Procedural Care through Outreach
Creators: Matthew A Uhlman - Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
Thomas S Gruca - Tippie College of Business, University of Iowa, Iowa City, Iowa
Craig A Jarvie - Department of Integrated Strategic Planning, University of Iowa, Iowa City, Iowa
George M Ghareeb - Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
Paul G Morrison - Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
Yu Han - Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
Kenneth G Nepple - Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
Bradley A Erickson - Department of Urology, Carver College of Medicine, University of Iowa, Iowa City, Iowa
Resource Type: Journal article
Publication Details: Urology Practice, Vol.4(4), pp.335-341
DOI: 10.1016/j.urpr.2016.07.006
ISSN: 2352-0779
Publisher: Elsevier Inc
Language: English
Date published: 07/2017
Academic Unit: Marketing; Urology
Record Identifier: 9983816374902771

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