# Two Decades of Ureteric Calculus Burden in Australia: National Trends in Incidence, Management, and Demographic Shifts

## TL;DR

This study tracks a significant rise in kidney stone cases in Australia over 19 years, along with changes in treatment and patient demographics.

## Contribution

The paper provides a comprehensive national analysis of ureteric calculus trends in Australia over two decades.

## Key findings

- The population-adjusted incidence of ureteric calculi increased by 95% from 2000-2001 to 2018-2019.
- Endoscopic stone destruction procedures rose by 323% in public hospitals compared to 48% in private hospitals.
- Interventions increased among adults aged ≥65 years and women over the study period.

## Abstract

Objective: To examine national trends in the incidence, management patterns, and demographic characteristics of patients presenting with ureteric calculi in Australia over a 19-year period.

Methodology: A retrospective population-based analysis was performed using three national datasets: the Australian Institute of Health and Welfare (AIHW), the Medicare Benefits Schedule (MBS), and the Australian Bureau of Statistics (ABS). Admissions and procedures associated with ureteric calculi from 2000-2001 to 2018-2019 were identified using the International Classification of Diseases, 10th Revision (ICD-10), and Australian Classification of Health Interventions (ACHI)/MBS procedural codes. Incidence rates were population-adjusted, and temporal trends were assessed using linear regression.

Results: Population-adjusted incidence of ureteric calculi rose by 95% (85.6 to 166.9 per 100,000) over the study period. Procedural interventions increased by 90% (34.0 to 64.7 per 100,000), while the national intervention rate remained stable at approximately 36%. Diagnoses of hydronephrosis with calculus obstruction showed the largest increase (481%). Public hospitals experienced a disproportionate rise in interventions, particularly endoscopic stone destruction (323% increase versus 48% in private hospitals). Interventions increased among adults ≥65 years and women. Same-day discharge rates increased for both conservative and interventional pathways, converging at approximately 45% by 2018-2019.

Conclusions: Australia has experienced a substantial rise in ureteric calculus burden accompanied by proportional increases in procedural interventions. Sector-specific and demographic shifts highlight evolving patterns in stone disease and healthcare utilization, with significant implications for future resource planning.