Ibukunoluwa I. Ibrahim, Daniel L. Zager, Leslie B. Charondo, Sophia Zamudio-Haas, Sara L. Ackerman, David B. Bayne
Abstract:
Traditional insurance claims dataset analyses have exposed disparities in treatment delays for kidney stones along lines of socio-economic status, particularly among patients who are underinsured and/or racial/ethnic minorities.
Introduction
Kidney stones affect an estimated 9.9% of people in the United States, and their prevalence is increasing [1,2]. Close to half of all patients who present to the Emergency Department (ED) for kidney stones do not receive any follow-up care [3]. Lack of follow-up has significant health consequences.
Materials and methods
We interviewed adult patients who were referred for urological care after presenting to the ED for kidney stones at hospitals within the University of California, San Francisco (UCSF) health system and failed to follow-up in the urology clinic 60 days after referral placement. Interviews offered the opportunity to learn about patients’ experiences seeking care for kidney stones.
Results:
Patient characteristics are summarized in Table 1. The time between ED and urology visits was a median of the 14 participants who completed follow-up within 365 days. No patient required emergent drainage or experienced sepsis. We identified three themes related to delays in care. The first theme evoked the substantial financial burden patients incurred related to stone disease.
Discussion
This formative study leveraged patients’ perspectives to describe the central barriers that created delays in kidney stone treatment, across the cascade of care. Previous qualitative studies have focused on changes in patients’ quality of life, but to our knowledge, this is the first to assess reasons for delays in treatment [9,21,22].
Conclusions
Our study provided important and actional able insights into patient perspectives on barriers to receiving care for kidney stones. This study has to be interpreted with caution because it only is composed of perspectives of 20 predominantly safety net hospital patients in a single region of one state. However, it does expose previously not described experiences of kidney stone patient who face care delays.
Citation: Ibrahim II, Zager DL, Charondo LB, Zamudio-Haas S, Ackerman SL, Bayne DB (2026) Patient perspectives on delays in care for kidney stones: A qualitative analysis. PLoS One 21(6): e0341787. https://doi.org/10.1371/journal.pone.0341787
Editor: Yung-Hsiang Chen, China Medical University, TAIWAN
Received: November 20, 2025; Accepted: May 7, 2026; Published: June 1, 2026
Copyright: © 2026 Ibrahim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
Funding: This work was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, University of California, San Francisco-Clinical & Translational Science Institute (UL1 TR001872 to SZH) and National Institute of Health K23 (1K23DK141906 to DBB). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
