The impact of a single disease site treatment facility on prostate cancer care in a community-hospital based radiation oncology practice

Abstract

6626 Background: The purpose of this study was to evaluate the pattern of care in a community-hospital based radiation oncology practice after the opening of a referring physician-owned single disease-site specific radiation oncology facility. Methods: Hospital data for radical prostatectomy, prostate seed implants, intensity modulated radiation therapy (IMRT) treatments, and radiation oncology department profit/loss were used to evaluate changes in the pattern of care for patients with prostate cancer at a community hospital located in Central Pennsylvania (PA) between 2003 and 2007. Commonwealth of PA public claims data were used to determine the frequency of radical prostatectomy at community-hospitals in the primary service area (PSA). Comparisons of the variables of interest were made to 2003. A free- standing radiation oncology center devoted to prostate cancer care located near the community hospital was opened in 7/06. Results: Table 1 depicts the percent change when compared to 2003 of the variables of interest by fiscal year. A negative number signifies a decrease when compared to 2003 and a positive number reflects an increase when compared to 2003. Commonwealth of PA data for radical prostatectomy for 2 community hospitals in the community hospital's PSA show a similar trend for a decrease in the use of radical prostatectomy. Conclusions: Absent any clinical data that would suggest a shift in outcomes, community practice appears to have changed with the opening of a referring physician owned free-standing radiation oncology facility devoted to prostate cancer care with a 22% and 80% decrease in prostate seed implants compared to prior to the center opening. The trend towards a reduction in the use of radical prostatectomy remained unchanged. Informed consent of all treatment options for patients with prostate cancer in this market has to be questioned with the dramatic reduction in the number of prostate seed implants. Radical Prostatectomy Prostate Seed Implant IMRT Treatments Radiation Oncology Department Profits 2004 -24% 8% 177% 126% 2005 -9% 1% 196% 129% 2006 -14% -22% 147% 59% 2007 -36% -80% -17% -50% No significant financial relationships to disclose.