Poster, Podium & Video Sessions
Presentation Authors: Alyssa Greiman*, Kit Simpson, Charleston, SC, Amit Patel, DuPage, IL, Sandip Prasad, Charleston, SC
Introduction: Fifty percent of patients with hematuria will have demonstrable causes. Full evaluation includes cystoscopy, urine cytology, and imaging. We determined patterns of care for hematuria evaluation in the insured population.
Methods: Utilizing a national administrative database of privately insured patients (Truven Health Analytics MarketScan® Research Database), we performed a cross-sectional analysis of men and women aged 40-65 years with newly diagnosed gross or microscopic hematuria in the calendar year 2013. Patients with pre-existing genitourinary diagnoses in the previous 12 months were excluded. The primary outcome was hematuria evaluation as assessed by the use of cystoscopy, urine cytology, and/or imaging for 6 months after a hematuria diagnosis identified by claims coding.
Results: We identified 22,514 and 69,310 patients with gross and microscopic hematuria, respectively; 44% of patients were male and 56% were female. Patients with gross and microscopic hematuria had complete evaluation in 6.3% and 5.2% and had no evaluation in 37.2% and 47.9% of cases, respectively (p<0.001 for all). For patients with gross and microscopic hematuria, 46.1% and 29.0% underwent cystoscopy, respectively (p<0.001). Performance of imaging and cytology are described in Table 1.
Conclusions: Among men and women with initial presentation of gross or microscopic hematuria, less than 6% of patients receive a complete evaluation with imaging, urine cytology and cystoscopic examination while over 48% have no evaluation. Practice patterns between gross and microscopic hematuria did not differ significantly, raising quality of care concerns that physicians treat these two conditions similarly despite significant differences in the natural history and the risk of urologic malignancies of these entities. Future studies should address causes for the discrepancies observed in the evaluation of hematuria.
Source Of Funding: none
Medical University of South Carolina
Alyssa Greiman is a PGY3 Urology Resident at the Medical University of South Carolina in Charleston, SC. She received her Bachelor of Science degree at Northwestern University in 2009 and then completed her medical school training at Feinberg School of Medicine, Northwestern University in 2014. She plans on pursuing a fellowship in Female Pelvic Medicine and Reconstructive Surgery after completing her residency training.
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