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Article Title

Multimorbidity Profile of Urologic Patients in a Large, Integrated Health Care Delivery System

Publication Date

8-10-2017

Keywords

rural health, aging, elderly, geriatrics, demographics, complex disease management, multiple chronic conditions, chronic disease, epidemiology

Abstract

Background: Two-thirds of urologic surgeries are performed in patients over 65 years old. As the American population ages, urologists are faced with increasingly complex older adults with multimorbidity. Our objective was to describe the multimorbidity profile of urologic patients in a large, integrated health care delivery system. We hypothesized that urologic patients are older and have more chronic conditions than the general primary care population.

Methods: We identified all Geisinger Health System (GHS) primary care patients from 2001 to 2015 and the subset that had at least one outpatient encounter in the urology department. The Agency for Healthcare Research and Quality’s Clinical Classifications Software tool was applied to identify prevalent conditions based on diagnosis codes attached to outpatient visits, laboratory and pharmacy orders, and procedures.

Results: We identified 390,271 GHS primary care patients; 33,085 had at least one urology outpatient visit (8.5%). Compared to the general GHS population, urology patients tended to be older (mean age: 48 years vs 61 years). Urology patients had a mean of 7 chronic conditions. The 5 most common conditions were hypertension, hyperlipidemia, prostate disorders, gastroesophageal reflux disease and other. The poster will include comparisons of urology population condition profiles to the GHS primary care population. We also will include chronic condition profiles by urologic condition.

Conclusion: Urologic patients were older compared to the general GHS primary care population and had significant numbers of chronic conditions. Multimorbidity profiles in the urologic population may be used to inform future efforts toward surgical prognostication and decision-making.

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