Utilization and Timing of Cystoscopy for Hematuria Evaluation by Advanced Practice Providers and Urologists
To characterize differences between urologists and advanced practice providers (APPs) in the utilization of cystoscopy for hematuria. We identified patients initially evaluated for hematuria by a urologist or urology APP between 2015 and 2020 in the MarketScan Research Databases. We determined wheth...
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| Published in: | Urology (Ridgewood, N.J.) Vol. 188; pp. 80 - 86 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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01.06.2024
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| ISSN: | 0090-4295, 1527-9995, 1527-9995 |
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| Abstract | To characterize differences between urologists and advanced practice providers (APPs) in the utilization of cystoscopy for hematuria.
We identified patients initially evaluated for hematuria by a urologist or urology APP between 2015 and 2020 in the MarketScan Research Databases. We determined whether they received a cystoscopy within 6 months of their urology visit and the number of days until cystoscopy. We used multivariable regression to analyze the association between these outcomes and whether the urology clinician was an advanced practice registered nurse (APRN), physician assistant (PA), or urologist.
We identified 34,470 patients with microscopic hematuria and 17,328 patients with gross hematuria. Patients evaluated by urologists more often received a same-day cystoscopy than those evaluated by APPs (13% vs 5.8%). The odds that patients evaluated for microscopic and gross hematuria received a cystoscopy were 46.2% and 26.2% lower, respectively, if they were evaluated by an APRN vs a urologist. Patients seeing an APRN for microscopic and gross hematuria also waited approximately 7 and 14 days longer for their cystoscopy, respectively. No differences were observed for patients evaluated by PAs vs urologists.
Patients evaluated for hematuria by an APRN were less likely to receive a cystoscopy and had a longer wait until the procedure compared to those evaluated by a urologist; however, no differences were observed between PAs and urologists. Better understanding APP integration into urology clinics is warranted. |
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| AbstractList | To characterize differences between urologists and advanced practice providers (APPs) in the utilization of cystoscopy for hematuria.
We identified patients initially evaluated for hematuria by a urologist or urology APP between 2015 and 2020 in the MarketScan Research Databases. We determined whether they received a cystoscopy within 6 months of their urology visit and the number of days until cystoscopy. We used multivariable regression to analyze the association between these outcomes and whether the urology clinician was an advanced practice registered nurse (APRN), physician assistant (PA), or urologist.
We identified 34,470 patients with microscopic hematuria and 17,328 patients with gross hematuria. Patients evaluated by urologists more often received a same-day cystoscopy than those evaluated by APPs (13% vs 5.8%). The odds that patients evaluated for microscopic and gross hematuria received a cystoscopy were 46.2% and 26.2% lower, respectively, if they were evaluated by an APRN vs a urologist. Patients seeing an APRN for microscopic and gross hematuria also waited approximately 7 and 14 days longer for their cystoscopy, respectively. No differences were observed for patients evaluated by PAs vs urologists.
Patients evaluated for hematuria by an APRN were less likely to receive a cystoscopy and had a longer wait until the procedure compared to those evaluated by a urologist; however, no differences were observed between PAs and urologists. Better understanding APP integration into urology clinics is warranted. To characterize differences between urologists and advanced practice providers (APPs) in the utilization of cystoscopy for hematuria.OBJECTIVETo characterize differences between urologists and advanced practice providers (APPs) in the utilization of cystoscopy for hematuria.We identified patients initially evaluated for hematuria by a urologist or urology APP between 2015 and 2020 in the MarketScan Research Databases. We determined whether they received a cystoscopy within 6 months of their urology visit and the number of days until cystoscopy. We used multivariable regression to analyze the association between these outcomes and whether the urology clinician was an advanced practice registered nurse (APRN), physician assistant (PA), or urologist.METHODSWe identified patients initially evaluated for hematuria by a urologist or urology APP between 2015 and 2020 in the MarketScan Research Databases. We determined whether they received a cystoscopy within 6 months of their urology visit and the number of days until cystoscopy. We used multivariable regression to analyze the association between these outcomes and whether the urology clinician was an advanced practice registered nurse (APRN), physician assistant (PA), or urologist.We identified 34,470 patients with microscopic hematuria and 17,328 patients with gross hematuria. Patients evaluated by urologists more often received a same-day cystoscopy than those evaluated by APPs (13% vs 5.8%). The odds that patients evaluated for microscopic and gross hematuria received a cystoscopy were 46.2% and 26.2% lower, respectively, if they were evaluated by an APRN vs a urologist. Patients seeing an APRN for microscopic and gross hematuria also waited approximately 7 and 14 days longer for their cystoscopy, respectively. No differences were observed for patients evaluated by PAs vs urologists.RESULTSWe identified 34,470 patients with microscopic hematuria and 17,328 patients with gross hematuria. Patients evaluated by urologists more often received a same-day cystoscopy than those evaluated by APPs (13% vs 5.8%). The odds that patients evaluated for microscopic and gross hematuria received a cystoscopy were 46.2% and 26.2% lower, respectively, if they were evaluated by an APRN vs a urologist. Patients seeing an APRN for microscopic and gross hematuria also waited approximately 7 and 14 days longer for their cystoscopy, respectively. No differences were observed for patients evaluated by PAs vs urologists.Patients evaluated for hematuria by an APRN were less likely to receive a cystoscopy and had a longer wait until the procedure compared to those evaluated by a urologist; however, no differences were observed between PAs and urologists. Better understanding APP integration into urology clinics is warranted.CONCLUSIONPatients evaluated for hematuria by an APRN were less likely to receive a cystoscopy and had a longer wait until the procedure compared to those evaluated by a urologist; however, no differences were observed between PAs and urologists. Better understanding APP integration into urology clinics is warranted. |
| Author | Cabral, Joshua Shewmon, Kate Modi, Parth K. Skolarus, Ted A. Bedziner, Moshe Hyman, Max J. Agarwal, Piyush K. |
| Author_xml | – sequence: 1 givenname: Max J. surname: Hyman fullname: Hyman, Max J. organization: The Center for Health and the Social Sciences, The University of Chicago, Chicago, IL – sequence: 2 givenname: Ted A. surname: Skolarus fullname: Skolarus, Ted A. organization: Section of Urology, Department of Surgery, The University of Chicago, Chicago, IL – sequence: 3 givenname: Joshua surname: Cabral fullname: Cabral, Joshua organization: Section of Urology, Department of Surgery, The University of Chicago, Chicago, IL – sequence: 4 givenname: Kate surname: Shewmon fullname: Shewmon, Kate organization: Section of Urology, Department of Surgery, The University of Chicago, Chicago, IL – sequence: 5 givenname: Moshe surname: Bedziner fullname: Bedziner, Moshe organization: Section of Urology, Department of Surgery, The University of Chicago, Chicago, IL – sequence: 6 givenname: Piyush K. surname: Agarwal fullname: Agarwal, Piyush K. organization: Section of Urology, Department of Surgery, The University of Chicago, Chicago, IL – sequence: 7 givenname: Parth K. surname: Modi fullname: Modi, Parth K. email: modi@bsd.uchicago.edu organization: Section of Urology, Department of Surgery, The University of Chicago, Chicago, IL |
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| Cites_doi | 10.1097/UPJ.0000000000000333 10.1016/j.urology.2023.03.049 10.1016/j.urology.2022.06.027 10.1097/01.JAA.0000515548.76484.39 10.1097/UPJ.0000000000000278 10.1016/j.urology.2016.07.028 10.1056/NEJMra1604481 10.1001/jamanetworkopen.2021.33864 10.1097/JU.0000000000001297 10.1016/j.urology.2017.03.047 10.1097/SLA.0000000000004846 10.1016/j.pedhc.2019.12.005 10.1016/j.juro.2018.04.065 10.1136/bmj.m4087 10.1111/j.1464-410X.2011.10664.x |
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We identified patients... To characterize differences between urologists and advanced practice providers (APPs) in the utilization of cystoscopy for hematuria.OBJECTIVETo characterize... |
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| SubjectTerms | Adult Aged Cystoscopy Female Hematuria - diagnosis Hematuria - etiology Humans Male Middle Aged Physician Assistants - statistics & numerical data Practice Patterns, Physicians' - statistics & numerical data Procedures and Techniques Utilization - statistics & numerical data Time Factors Urologists - statistics & numerical data Urology |
| Title | Utilization and Timing of Cystoscopy for Hematuria Evaluation by Advanced Practice Providers and Urologists |
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