title: Failing to follow up: predicting patients that will "no-show" for medically advised imaging following endourologic stone surgery.
abstract: BACKGROUND
  The purpose of this study is to evaluate predictors of poor compliance after treatment of urinary stone disease.
  
  
  METHODS
  This study was a retrospective analysis of patients who underwent stent removal following percutaneous nephrolithotomy (PCNL) or ureteroscopy (URS) between 2008-2012. All patients were scheduled for follow up evaluation and renal ultrasound at 4-6 weeks following stent removal. Patients were stratified based on appointment compliance and demographic variables including gender, age, insurance type (Government Assisted Insurance [GAI] or Private Insurance [PI]), initial procedure, season, distance between home and clinic, average monthly gas price at follow up, and median education attainment. Logistic regression was performed to determine independent predictors of missed follow up.
  
  
  RESULTS
  A total of 301 patients were included, 153 women (51% female) with a mean age of 54 ± 14.2 years. Of the cohort, 22.6% (n = 68) did not return for follow up. GAI was the only variable associated with a greater risk of non-compliance on univariate analysis (OR 2.13 [95% CI 1.12-3.86] p = 0.011) and multivariate analysis (OR 3.14.10 [95% CI 1.48-6.7], p < 0.01). Gender, age, procedure, season, distance, gas prices, and education were not significant predictors.
  
  
  CONCLUSIONS
  In our study, evaluating characteristics associated with missed follow up after stent removal for PCNL and URS, possession of GAI was the only factor associated with non-compliance. Urologists should be aware that persons with GAI may be at increased risk of missed follow up and should use this information to target interventions to improve compliance.
authors.affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Moses
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dagrosa
authors.forename: Elias S
authors.initials: ES
authors.lastname: Hyams
authors.forename: Peter L
authors.initials: PL
authors.lastname: Steinberg
authors.forename: Vernon M
authors.initials: VM
authors.lastname: Pais
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D007668:Kidney / Q000000981:diagnostic imaging*; D016015:Logistic Models; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011336:Probability; D011859:Radiography; D012189:Retrospective Studies; D012621:Seasons; D012737:Sex Factors; D014463:Ultrasonography; D018666:Ureteroscopy; D014545:Urinary Calculi / Q000601:surgery*