Declining utilization of urodynamic studies in urological care in Germany: time to say goodbye?
Introduction The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline. Material &...
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| Vydané v: | World journal of urology Ročník 42; číslo 1; s. 440 |
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| Hlavní autori: | , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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Berlin/Heidelberg
Springer Berlin Heidelberg
24.07.2024
Springer Nature B.V |
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| ISSN: | 1433-8726, 0724-4983, 1433-8726 |
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| Abstract | Introduction
The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline.
Material & methods
We surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023. We examined structural situation, waiting times, capacities and limitations of UDS. All invasive urodynamic examinations were defined as UDS.
Results
In 2019, 259/474 (55%) urological departments in Germany performed UDS. 206/259 (80%) urological departments responded to the survey. 163/200 (82%) urological departments stated that their capacities were exhausted, a main reason being lack of medical and nursing staff. 54.8% urological departments performed more than 50% of their UDS for referring physicians. Urological departments with a low number of UDS/year (≤ 100) showed a shorter waiting time (up to 4 weeks: 49% vs. 30%;
p
= 0.01), reduced UDS capacities (55% vs. 12%;
p
< 0.001) and these capacities were often not fully utilized (25% vs. 9%;
p
= 0.007). 122/280 (44%) office urologists responded to the survey. 18/122 (15%) office urologists performed UDS. Main reasons for not offering UDS were lack of personnel and low reimbursement.
Conclusion
In German urological departments, UDS capacities are consistently fully utilized, primarily due to staffing shortages. This trend towards centralization prompts questions about the role of UDS in urologists’ training. |
|---|---|
| AbstractList | Introduction
The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline.
Material & methods
We surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023. We examined structural situation, waiting times, capacities and limitations of UDS. All invasive urodynamic examinations were defined as UDS.
Results
In 2019, 259/474 (55%) urological departments in Germany performed UDS. 206/259 (80%) urological departments responded to the survey. 163/200 (82%) urological departments stated that their capacities were exhausted, a main reason being lack of medical and nursing staff. 54.8% urological departments performed more than 50% of their UDS for referring physicians. Urological departments with a low number of UDS/year (≤ 100) showed a shorter waiting time (up to 4 weeks: 49% vs. 30%;
p
= 0.01), reduced UDS capacities (55% vs. 12%;
p
< 0.001) and these capacities were often not fully utilized (25% vs. 9%;
p
= 0.007). 122/280 (44%) office urologists responded to the survey. 18/122 (15%) office urologists performed UDS. Main reasons for not offering UDS were lack of personnel and low reimbursement.
Conclusion
In German urological departments, UDS capacities are consistently fully utilized, primarily due to staffing shortages. This trend towards centralization prompts questions about the role of UDS in urologists’ training. The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline.INTRODUCTIONThe number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline.We surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023. We examined structural situation, waiting times, capacities and limitations of UDS. All invasive urodynamic examinations were defined as UDS.MATERIAL & METHODSWe surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023. We examined structural situation, waiting times, capacities and limitations of UDS. All invasive urodynamic examinations were defined as UDS.In 2019, 259/474 (55%) urological departments in Germany performed UDS. 206/259 (80%) urological departments responded to the survey. 163/200 (82%) urological departments stated that their capacities were exhausted, a main reason being lack of medical and nursing staff. 54.8% urological departments performed more than 50% of their UDS for referring physicians. Urological departments with a low number of UDS/year (≤ 100) showed a shorter waiting time (up to 4 weeks: 49% vs. 30%; p = 0.01), reduced UDS capacities (55% vs. 12%; p < 0.001) and these capacities were often not fully utilized (25% vs. 9%; p = 0.007). 122/280 (44%) office urologists responded to the survey. 18/122 (15%) office urologists performed UDS. Main reasons for not offering UDS were lack of personnel and low reimbursement.RESULTSIn 2019, 259/474 (55%) urological departments in Germany performed UDS. 206/259 (80%) urological departments responded to the survey. 163/200 (82%) urological departments stated that their capacities were exhausted, a main reason being lack of medical and nursing staff. 54.8% urological departments performed more than 50% of their UDS for referring physicians. Urological departments with a low number of UDS/year (≤ 100) showed a shorter waiting time (up to 4 weeks: 49% vs. 30%; p = 0.01), reduced UDS capacities (55% vs. 12%; p < 0.001) and these capacities were often not fully utilized (25% vs. 9%; p = 0.007). 122/280 (44%) office urologists responded to the survey. 18/122 (15%) office urologists performed UDS. Main reasons for not offering UDS were lack of personnel and low reimbursement.In German urological departments, UDS capacities are consistently fully utilized, primarily due to staffing shortages. This trend towards centralization prompts questions about the role of UDS in urologists' training.CONCLUSIONIn German urological departments, UDS capacities are consistently fully utilized, primarily due to staffing shortages. This trend towards centralization prompts questions about the role of UDS in urologists' training. IntroductionThe number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline.Material & methodsWe surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023. We examined structural situation, waiting times, capacities and limitations of UDS. All invasive urodynamic examinations were defined as UDS.ResultsIn 2019, 259/474 (55%) urological departments in Germany performed UDS. 206/259 (80%) urological departments responded to the survey. 163/200 (82%) urological departments stated that their capacities were exhausted, a main reason being lack of medical and nursing staff. 54.8% urological departments performed more than 50% of their UDS for referring physicians. Urological departments with a low number of UDS/year (≤ 100) showed a shorter waiting time (up to 4 weeks: 49% vs. 30%; p = 0.01), reduced UDS capacities (55% vs. 12%; p < 0.001) and these capacities were often not fully utilized (25% vs. 9%; p = 0.007). 122/280 (44%) office urologists responded to the survey. 18/122 (15%) office urologists performed UDS. Main reasons for not offering UDS were lack of personnel and low reimbursement.ConclusionIn German urological departments, UDS capacities are consistently fully utilized, primarily due to staffing shortages. This trend towards centralization prompts questions about the role of UDS in urologists’ training. The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline. We surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023. We examined structural situation, waiting times, capacities and limitations of UDS. All invasive urodynamic examinations were defined as UDS. In 2019, 259/474 (55%) urological departments in Germany performed UDS. 206/259 (80%) urological departments responded to the survey. 163/200 (82%) urological departments stated that their capacities were exhausted, a main reason being lack of medical and nursing staff. 54.8% urological departments performed more than 50% of their UDS for referring physicians. Urological departments with a low number of UDS/year (≤ 100) showed a shorter waiting time (up to 4 weeks: 49% vs. 30%; p = 0.01), reduced UDS capacities (55% vs. 12%; p < 0.001) and these capacities were often not fully utilized (25% vs. 9%; p = 0.007). 122/280 (44%) office urologists responded to the survey. 18/122 (15%) office urologists performed UDS. Main reasons for not offering UDS were lack of personnel and low reimbursement. In German urological departments, UDS capacities are consistently fully utilized, primarily due to staffing shortages. This trend towards centralization prompts questions about the role of UDS in urologists' training. |
| ArticleNumber | 440 |
| Author | Thomas, Christian Mehralivand, Sherif Huber, Johannes Schultz-Lampel, Daniela Eisenmenger, Nicole Menzel, Viktoria Grabbert, Markus Baunacke, Martin Kontschak, Livia Borkowetz, Angelika |
| Author_xml | – sequence: 1 givenname: Martin orcidid: 0000-0002-5601-7587 surname: Baunacke fullname: Baunacke, Martin email: martin.baunacke@ukdd.de organization: Department of Urology, TU Dresden – sequence: 2 givenname: Livia surname: Kontschak fullname: Kontschak, Livia organization: Department of Urology, TU Dresden – sequence: 3 givenname: Viktoria surname: Menzel fullname: Menzel, Viktoria organization: Department of Urology, TU Dresden – sequence: 4 givenname: Markus surname: Grabbert fullname: Grabbert, Markus organization: Department of Urology, University of Freiburg – sequence: 5 givenname: Angelika surname: Borkowetz fullname: Borkowetz, Angelika organization: Department of Urology, TU Dresden – sequence: 6 givenname: Sherif surname: Mehralivand fullname: Mehralivand, Sherif organization: Department of Urology, TU Dresden – sequence: 7 givenname: Nicole surname: Eisenmenger fullname: Eisenmenger, Nicole organization: Reimbursement Institute – sequence: 8 givenname: Johannes surname: Huber fullname: Huber, Johannes organization: Department of Urology, Philipps-University Marburg – sequence: 9 givenname: Christian surname: Thomas fullname: Thomas, Christian organization: Department of Urology, TU Dresden – sequence: 10 givenname: Daniela surname: Schultz-Lampel fullname: Schultz-Lampel, Daniela organization: Southwest Continence Center, Schwarzwald-Baar-Klinikum |
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| Keywords | Urodynamic studies Continence Epidemiology Health services research |
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| Snippet | Introduction
The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood.... The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study... IntroductionThe number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood.... |
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| StartPage | 440 |
| SubjectTerms | Germany Humans Medicine Medicine & Public Health Nephrology Oncology Procedures and Techniques Utilization - statistics & numerical data Surveys Urodynamics Urology |
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| Title | Declining utilization of urodynamic studies in urological care in Germany: time to say goodbye? |
| URI | https://link.springer.com/article/10.1007/s00345-024-05154-3 https://www.ncbi.nlm.nih.gov/pubmed/39046605 https://www.proquest.com/docview/3084092993 https://www.proquest.com/docview/3084028530 https://pubmed.ncbi.nlm.nih.gov/PMC11269447 |
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