US Pharm. 2013;8(38):7.

The National Health Interview Survey noted that 2% of individuals aged 18 years and older were diagnosed with kidney disease in 2011. Kidney disease was more than three times more prevalent in poor families than in better-off families. Among patients aged 65 years and younger, Medicaid covered kidney disease treatment in six times more patients than private insurance companies did. Three times more patients older than 65 years who had both Medicaid and Medicare were covered, versus those with private insurance or those with Medicare only (2.4 times). Urinary tract infections (UTIs) generated 8.1 million office visits to physicians, with 5% of visits to a primary care physician.

Hospice Care: Of all listed diagnoses for hospice care, 3.4% of patients (35,900) were diagnosed with malignant neoplasm of urinary organs, according to the 2011 National Home and Hospice Care Survey. Of the 14.5% of patients diagnosed with disease of the genitourinary system at discharge from hospice, 20% had a UTI.

Ambulatory Care: The National Ambulatory Medical Care Survey determined that in 2009, of the 22 million visits to office-based urologists, 33% of patients were aged 45 to 64 years, 26% were 65 to 74 years, and 24% were 75 years and older; however, the number of annual visits was three times greater in the group aged 45 to 64 years than in the group aged 65 to 74 years. Compared with men, women made three times more annual visits to urologists. Preventive care (5%) was the least frequent reason for visiting a urologist in an ambulatory care setting; the most common reasons were a chronic problem (42%), a new problem (26%), presurgical or postsurgical visits (13%), and flareup of a chronic problem (12%). The most common diagnoses during office visits were malignant neoplasm, prostatic hyperplasia, incontinence, retention, dysuria, and renal or ureteral calculi. The urologist prescribed a medication (e.g., tamsulosin, aspirin, ciprofloxacin, lisinopril, simvastatin) in 64% of visits.

Short-Stay Hospitalization and Home Health Care: In 2010, 55% more patients aged 45 to 64 years than those aged 15 to 44 years underwent urinary-system surgery. Compared with patients aged 45 to 64 years, 22% more patients aged 65 years and older underwent procedures. Cystoscopy with or without biopsy was performed on 35% more people aged 45 to 64 years than those aged 15 to 44 years, and an additional 5% of those aged 65 years and older underwent the procedure. Following diseases of the respiratory system, the seventh most common ailment experienced by patients (14.7%) in home health care settings was disease of the genitourinary system. Nearly half of these patients had UTIs.

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