Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Division of Urology, Department of Surgery, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA.
Curr Urol Rep. 2020 Mar 31;21(5):18. doi: 10.1007/s11934-020-00971-6.
From health systems to individuals, nephrolithiasis is economically burdensome. The aim of the current paper is to characterize the financial burden of disease associated with nephrolithiasis with an emphasis on investigating treatment modality economic efficiency.
For small volume practices and cases where there is high risk of scope damage, disposable flexible ureteroscope utilization seems to provide economic efficiency. The rise in global prevalence of stone disease is a large contributing factor to increasing costs associated with nephrolithiasis. A large proportion of costs from kidney stones stem from ED visits and inpatient care. There are opportunities to save money by transitioning care to outpatient settings in scenarios that allow such transition. Metaphylaxis and prevention strategies are effective at lowering costs in properly selected patient populations. Flexible ureteroscopy and percutaneous nephrolithotomy (PCNL) are the most economically efficient methods of surgically treating stone disease, with PCNL being reserved for large and lower pole stones. Time off work and other indirect costs, while challenging to quantify, are important considerations in the economics of nephrolithiasis.
从卫生系统到个人，肾结石都造成了巨大的经济负担。本文的目的是分析肾结石相关疾病的经济负担，并重点研究治疗方式的经济效率。
对于小容量手术和存在高镜体损坏风险的病例，一次性使用软性输尿管镜似乎具有经济效率。全球结石病患病率的上升是导致肾结石相关费用增加的一个重要因素。肾结石的大部分费用来自急诊科就诊和住院治疗。在允许这种转变的情况下，将护理转为门诊护理可以节省开支。预防和辅助治疗策略在适当选择的患者人群中可有效降低成本。软性输尿管镜和经皮肾镜碎石术（PCNL）是治疗结石病最具经济效率的方法，PCNL 适用于大结石和下极结石。旷工和其他间接成本虽然难以量化，但在肾结石的经济学中是需要考虑的重要因素。
