PD52-01 ASSOCIATION BETWEEN RADIATION FACILITY OWNERSHIP AND VARIATION IN PROSTATE CANCER TREATMENT AND SPENDING

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life & Shared Decision Making III1 Apr 2018PD52-01 ASSOCIATION BETWEEN RADIATION FACILITY OWNERSHIP AND VARIATION IN PROSTATE CANCER TREATMENT AND SPENDING Tudor Borza, Phyllis Yan, Samuel R. Kaufman, Lindsey Herrel, Ted A. Skolarus, Vahakn B. Shahinian, and Brent Hollenbeck Tudor BorzaTudor Borza More articles by this author , Phyllis YanPhyllis Yan More articles by this author , Samuel R. KaufmanSamuel R. Kaufman More articles by this author , Lindsey HerrelLindsey Herrel More articles by this author , Ted A. SkolarusTed A. Skolarus More articles by this author , Vahakn B. ShahinianVahakn B. Shahinian More articles by this author , and Brent HollenbeckBrent Hollenbeck More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2353AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Differences in prostate cancer treatment arise from multiple patient and disease factors. Financial incentives from radiation facility ownership may serve as additional sources of variation. Herein, we characterize the variation in prostate cancer treatment and spending and examine the effect of radiation facility ownership on this. METHODS We used a 20% Medicare sample to perform a retrospective cohort study of men with newly diagnosed prostate cancer between 2010 and 2013. Urologists were categorized by their practice affiliation (single specialty vs. multispecialty group) and ownership of a radiation facility. For single specialty groups, generalized estimating equations adjusting for patient variables were used to calculate rates of treatment within one year of diagnosis, potential overtreatment (i.e. treatment in patients with a 10-year risk of non-cancer mortality exceeding 75%) and annual price standardized per-beneficiary spending. RESULTS We identified 19,063 men who were cared for by urologists affiliated with one of 561 single specialty groups, 88 of which were radiation facility owners. The mean rate of initial treatment was 70% with wide variation noted among groups (range 47%-87%, Figure). The mean rate of potential overtreatment was 44% (range 15%-80%) and mean annual spending was $20,668 (range $12,865-$34,964). Only 16% of radiation facility owning groups had initial treatment rates below the mean while 57% were in the highest quartile with similar trends noted in potential overtreatment. For annual spending, only 11% of radiation facility owning groups were below the mean and 68% were in the highest quartile. CONCLUSIONS We observed wide variation in rates of treatment and spending among single specialty urology groups. The majority of groups with radiation facility ownership had rates of initial treatment, potential overtreatment and annual spending in the highest quartile. Radiation facility ownership appears to play a role in how patients with newly diagnosed prostate cancer are treated. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e980-e981 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Tudor Borza More articles by this author Phyllis Yan More articles by this author Samuel R. Kaufman More articles by this author Lindsey Herrel More articles by this author Ted A. Skolarus More articles by this author Vahakn B. Shahinian More articles by this author Brent Hollenbeck More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...