{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T21:22:26Z","timestamp":1771190546847,"version":"3.50.1"},"reference-count":0,"publisher":"Canadian Urological Association Journal","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CUAJ"],"abstract":"<jats:p>Introduction: We sought to evaluate population-based cost variations and predictors of outlier costs for percutaneous nephrolithotomy (PCNL) in the U.S.\r\nMethods: Using the Premier Healthcare Database, we identified all patients diagnosed with kidney\/ureter calculus who underwent PCNL from 2003\u20132015. We evaluated 90-day direct hospital costs, defining high- and low-cost surgery as those &gt;90th and &lt;10th percentile, respectively. We constructed a multilevel, hierarchical regression model and calculated the pseudo-R2 of each variable, which translates to the percentage variability contributed by that variable on 90-day direct hospital costs.\r\nResults: A total of 114 581 patients underwent PCNL during the 12-year study period. Mean cost in the low-cost group was $5787 (95% confidence interval [CI] 5716\u20135856) vs. $38 590 (95% CI 37 357\u201339 923) in the high-cost group. Cost variations were substantially impacted by patient (63.7%) and surgical (18.5%) characteristics and less so by hospital characteristics (3.9%). Significant predictors of high costs included more comorbidities (\u22652 vs. 0: odds ratio [OR] 1.81; p=0.01) and hospital region (Northeast vs. Midwest: OR 2.04; p=0.03). Predictors of low cost were hospital bed size of 300\u2013499 beds (OR 1.35; p&lt;0.01) and urban hospitals (OR 2.77; p=0.01). Factors less likely to be associated with lowcost PCNL were more comorbidities (Charlson Comorbidity Index [CCI] \u22652: OR 0.69; p&lt;0.0001), larger hospitals (OR 0.61; p=0.01), and teaching hospitals (OR 0.33; p&lt;0.0001).\r\nConclusions: Our contemporary analysis demonstrates that patient and surgical characteristics had a significant effect on costs associated with PCNL. Poor comorbidity status contributed to high costs, highlighting the importance of patient selection.<\/jats:p>","DOI":"10.5489\/cuaj.5280","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T17:27:29Z","timestamp":1529429249000},"source":"Crossref","is-referenced-by-count":9,"title":["Costs variations for percutaneous nephrolithotomy in the U.S. from 2003\u20132015: A contemporary analysis of an all-payer discharge database"],"prefix":"10.5489","volume":"12","author":[{"given":"Jeffrey J.","family":"Leow","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Sophie","family":"Valiquette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin I.","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven L.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quoc-Dien","family":"Trinh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rus","family":"Korets","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naeem","family":"Bhojani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3456","published-online":{"date-parts":[[2018,6,19]]},"container-title":["Canadian Urological Association Journal"],"original-title":[],"link":[{"URL":"https:\/\/cuaj.ca\/index.php\/journal\/article\/download\/5280\/3946","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/cuaj.ca\/index.php\/journal\/article\/download\/5280\/3724","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,7,7]],"date-time":"2019-07-07T06:10:32Z","timestamp":1562479832000},"score":1,"resource":{"primary":{"URL":"https:\/\/cuaj.ca\/index.php\/journal\/article\/view\/5280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,19]]},"references-count":0,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2018,6,19]]}},"URL":"https:\/\/doi.org\/10.5489\/cuaj.5280","relation":{},"ISSN":["1920-1214","1911-6470"],"issn-type":[{"value":"1920-1214","type":"electronic"},{"value":"1911-6470","type":"print"}],"subject":[],"published":{"date-parts":[[2018,6,19]]}}}