Abstracts from the New England Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Scientific Session VI: General Urology, Clinical Practice and Academics Differences in Healthcare Expenditures and Utilization by Race for Common Benign Urologic Conditions Michael Rezaee, MD, MPH 1 , Charlotte Ward, PhD 2 , Martin Gross, MD 1 1 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; 2 Dartmouth College, Lebanon, NH, USA Introduction: Little is known about racial disparities in the care of urology patients. We sought to identify differences in healthcare expenditures and utilization by race in patients treated for common benign urologic conditions. Materials&Methods: Aretrospective secondary data analysiswas conducted of patients with common benign urologic conditions using 2016-2018Medical Expenditure Panel Survey data. Benign conditions included urolithiasis, cystitis, erectile dysfunction (ED), pelvic organ prolapse (POP), urinary incontinence (UI), and benign prostatic hyperplasia (BPH). Generalized linear models were used to evaluate the relationship between total healthcare expenditures and utilization and race for each condition. Adjusted analyses accounted for age, sex, number of chronic conditions, poverty category, self-reported health status, marital status, highest degree of educational attainment, insurance status, and survey year. Results: The weighted analysis sample consisted of 27,110,416 patients, of whom 80.9%were Non-Hispanic white, 6.9%Non-Hispanic black, and 12.2% other minority races. After adjustment, total healthcare expenditures were significantly lower for Non-Hispanic blacks (Incidence Rate Ratio [IRR] = 0.19, 95% CI: 0.06 - 0.61) and other minority races (IRR = 0.30, 95% CI: 0.10 - 0.88) treated for ED compared to Non-Hispanic whites (Figure 1). Similarly, compared toNon-Hispanic whites, healthcare expenditures were significantly lower for Non-Hispanic blacks treated for UI (IRR = 0.56, 95% CI: 0.35 - 0.90). After adjustment, Non-Hispanic blacks (IRR = 0.71, 95% CI: 0.53 - 0.94) and other minority races (IRR = 0.83, 95% CI: 0.69 - 0.99) had significantly lower total healthcare utilization for cystitis and BPH respectively. Conclusions: Healthcare expenditures are significantly lower for Non- Hispanic blacks treated for ED and UI in the U.S. Utilization is also significantly lower for Non-Hispanic blacks and other minority races treated for cystitis and BPH respectively. Future research is needed to determine if these differences represent an inequality in the delivery of urologic care for patients with these conditions. 64 Optimizing Patient Selection for Telehealth: Results from a Large-Scale Urology Telehealth Implementation Kenneth A. Softness, MD , Sumedh Kaul, MS, Aaron Fleishman, MPH, Peter F. Chang, MD, Andrew Wagner, MD, Anurag K. Das, MD, Heidi Rayala, MD, PhD, Peter L. Steinberg, MD, Ruslan Korets, MD, Aria Olumi, MD, Boris Gershman, MD Beth Israel Deaconess Medical Center, Boston, MA, USA Introduction: Telehealth has a number of potential benefits for patients and providers, including reductions in time and cost required to obtain healthcare, expanded access to specialty providers, and reductions in existing healthcare disparities. Despite these benefits, patients vary in their satisfaction with the telehealth experience. Herein, we characterized patient satisfaction with telehealth visits and evaluated predictors of satisfaction with telehealth visits to improve patient selection when booking telehealth visits. Materials & Methods: We invited patients who had a telephonic or video telehealth visit from April-May 2020 at our institution to complete an online survey, via single-wave email invitation. We abstracted baseline characteristics for respondents from the medical record, and linked zip-code level socioeconomic data from the US Census. To improve patient selection for telehealth, we used univariable logistic regression to evaluate the associations of baseline characteristics with patient preference for telehealth over an in- person visit for a future encounter. Results: 58 respondents (22% response rate) were included in the study, of whom 79% were male, 91% were white, and 45% of were privately insured. This was the first telehealth experience for 69% of patients. Reasons for consultation were: oncologic in 48%, nephrolithiasis in 10%, BPH/voiding dysfunction in 34%, and other in 7% of patients. Overall, 93% of patients would recommend telehealth to a friend/family member. When asked their preferred format for a future visit, 51% responded telehealth while 49% responded traditional, in-person visit. Additional survey responses are summarized in Figure 1 . On univariable regression, having a prior telehealth visit was associated with preference for future telehealth visit format (OR 3.74; 95% CI 1.16-13.6); self-reported tech-savviness did not reach statistical significance (OR 3.47; 95% CI 0.99-14.3). Conclusions: In this study, respondents reported high satisfaction with telehealth visits. Prior telehealth experience was the best predictor of patient preference for a future telehealth visit. These results suggest allowing patients to choose their preferred visit format may be a simple mechanism for optimizing patient satisfaction with telehealth. 63 32