[URETERAL STONES ECONOMICS: FACTORS INFLUENCING URETERAL STONES TREATMENT COSTS].

Introduction: Urolithiasis imposes a significant financial burden on healthcare systems.

Aims: To investigate the factors influencing the treatment costs of ureteral stones.

Methods: A cross-sectional study was performed based on a retrospective cohort of Emergency Department (ED) patients with CT proven ureteric stone. Clinical, laboratory and imaging data were collected, including data on hospital admissions, ED readmissions, procedures, and total treatment cost.

Results: During the period 2018 - 2020, 805 ED patients were identified on CT with ureteral stone, of whom 773 met the inclusion criteria. Treatment costs were directly related to the patient's age: NIS 15,125 for 18-30 year olds, NIS 19,225 for 31-50 year old patients, NIS 22,866 for patients aged 51-70 years, and NIS 34,665 for patients over 70 years (p<0.001). Female patients incurred NIS 5,190 higher costs than male patients (p=0.03). Stone size and location were also associated with increased costs: <5mm (NIS 11,773), 5-10mm (NIS 34,500), and >10mm (NIS 58,340) (p<0.001); NIS 37,067 vs NIS 14,764 for proximal and distal stones respectively (p<0.001). Positive urine culture (p<0.001), elevated CRP (p<0.001), lower GFR (p=0.002) and concomitant renal stones (p<0.001) were associated with higher treatment costs. Prior renal drainage increased costs by NIS 7,450 (p<0.001). Stone composition also affected costs, with struvite stones being the most expensive to treat (NIS 53,552) (p<0.001).

Conclusions: Treatment costs are primarily influenced by patient age, stone size, location and composition. Additionally, the presence of an infectious state increases the overall treatment costs.