Patient Driven Care in the Management of Prostate Cancer: Analysis of the United States Military Healthcare System

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2017 Jul 12

PMID 28693554

Citations 4

Authors

Muhammad Ali Chaudhary

Jeffrey J Leow

Matthew Mossanen

Ritam Chowdhury

Wei Jiang

Peter A Learn

Joel S Weissman

Steven L Chang

Affiliations

Soon will be listed here.

Abstract

Background: Patient preferences are assumed to impact healthcare resource utilization, especially treatment options. There is limited data exploring this phenomenon. We sought to identify factors associated with patients transferring care for prostatectomy, from military to civilian facilities, and the receipt of minimally invasive radical prostatectomy (MIRP).

Methods: Retrospective review of 2006-2010 TRICARE data identified men diagnosed with prostate cancer (ICD-9 185) receiving open radical prostatectomy (ORP; ICD-9: 60.5) or MIRP (ICD-9 60.5 + 54.21/17.42). Patients diagnosed at military facilities but underwent surgery at civilian facilities were defined as "transferring care". Logistic regression models identified predictors of transferring care for patients diagnosed at military facilities. A secondary analysis identified the predictors of MIRP receipt at civilian facilities.

Results: Of 1420 patients, 247 (17.4%) transferred care. These patients were more likely to undergo MIRP (OR = 7.83, p < 0.01), and get diagnosed at low-volume military facilities (OR = 6.10, p < 0.01). Our secondary analysis demonstrated that transferring care was strongly associated with undergoing MIRP (OR = 1.51, p = 0.04).

Conclusions: Patient preferences induced a demand for greater utilization of MIRP and civilian facilities. Further work exploring factors driving these preferences and interventions tailoring them, based on evidence and cost considerations, is required.

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References

Liu J, Maxwell B, Panousis P, Chung B . Perioperative outcomes for laparoscopic and robotic compared with open prostatectomy using the National Surgical Quality Improvement Program (NSQIP) database. Urology. 2013; 82(3):579-83. DOI: 10.1016/j.urology.2013.03.080. View

Pope G, Kautter J, Ellis R, Ash A, Ayanian J, Lezzoni L . Risk adjustment of Medicare capitation payments using the CMS-HCC model. Health Care Financ Rev. 2004; 25(4):119-41. PMC: 4194896. View

Trinh Q, Bjartell A, Freedland S, Hollenbeck B, Hu J, Shariat S . A systematic review of the volume-outcome relationship for radical prostatectomy. Eur Urol. 2013; 64(5):786-98. PMC: 4109273. DOI: 10.1016/j.eururo.2013.04.012. View

Hauber A, Arellano J, Qian Y, Gonzalez J, Posner J, Mohamed A . Patient preferences for treatments to delay bone metastases. Prostate. 2014; 74(15):1488-97. DOI: 10.1002/pros.22865. View

Yaxley J, Coughlin G, Chambers S, Occhipinti S, Samaratunga H, Zajdlewicz L . Robot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: early outcomes from a randomised controlled phase 3 study. Lancet. 2016; 388(10049):1057-1066. DOI: 10.1016/S0140-6736(16)30592-X. View

Weeks W, Jardin M, Dufour J, Paraponaris A, Ventelou B . Geographic variation in admissions for knee replacement, hip replacement, and hip fracture in France: evidence of supplier-induced demand in for-profit and not-for-profit hospitals. Med Care. 2014; 52(10):909-17. DOI: 10.1097/MLR.0000000000000211. View

Trinh Q, Sammon J, Sun M, Ravi P, Ghani K, Bianchi M . Perioperative outcomes of robot-assisted radical prostatectomy compared with open radical prostatectomy: results from the nationwide inpatient sample. Eur Urol. 2011; 61(4):679-85. DOI: 10.1016/j.eururo.2011.12.027. View

Chowdhury R, Davis W, Chaudhary M, Jiang W, Zogg C, Schoenfeld A . Race-based differences in duration of stay among universally insured coronary artery bypass graft patients in military versus civilian hospitals. Surgery. 2016; 161(4):1090-1099. DOI: 10.1016/j.surg.2016.10.022. View

Delamater P, Messina J, Grady S, WinklerPrins V, Shortridge A . Do more hospital beds lead to higher hospitalization rates? a spatial examination of Roemer's Law. PLoS One. 2013; 8(2):e54900. PMC: 3572098. DOI: 10.1371/journal.pone.0054900. View

10.

Teplensky J, Pauly M, Kimberly J, Hillman A, Schwartz J . Hospital adoption of medical technology: an empirical test of alternative models. Health Serv Res. 1995; 30(3):437-65. PMC: 2495089. View

11.

Bradford W, Kleit A, Nietert P, Steyer T, McIlwain T, Ornstein S . How direct-to-consumer television advertising for osteoarthritis drugs affects physicians' prescribing behavior. Health Aff (Millwood). 2006; 25(5):1371-7. DOI: 10.1377/hlthaff.25.5.1371. View

12.

Lawthers A, McCarthy E, Davis R, Peterson L, Palmer R, Iezzoni L . Identification of in-hospital complications from claims data. Is it valid?. Med Care. 2000; 38(8):785-95. DOI: 10.1097/00005650-200008000-00003. View

13.

Eilat-Tsanani S, Tabenkin H, Shental J, Elmalah I, Steinmetz D . Patients' perceptions of radical prostatectomy for localized prostate cancer: a qualitative study. Isr Med Assoc J. 2013; 15(3):153-7. View

14.

Heidenreich A, Aus G, Bolla M, Joniau S, Matveev V, Schmid H . EAU guidelines on prostate cancer. Eur Urol. 2007; 53(1):68-80. DOI: 10.1016/j.eururo.2007.09.002. View

15.

Chang S, Kibel A, Brooks J, Chung B . The impact of robotic surgery on the surgical management of prostate cancer in the USA. BJU Int. 2014; 115(6):929-36. DOI: 10.1111/bju.12850. View

16.

Zogg C, Jiang W, Chaudhary M, Scott J, Shah A, Lipsitz S . Racial disparities in emergency general surgery: Do differences in outcomes persist among universally insured military patients?. J Trauma Acute Care Surg. 2016; 80(5):764-75. DOI: 10.1097/TA.0000000000001004. View

17.

Mirkin J, Lowrance W, Feifer A, Mulhall J, Eastham J, Elkin E . Direct-to-consumer Internet promotion of robotic prostatectomy exhibits varying quality of information. Health Aff (Millwood). 2012; 31(4):760-9. PMC: 3897330. DOI: 10.1377/hlthaff.2011.0329. View

18.

Alkhateeb S, Lawrentschuk N . Consumerism and its impact on robotic-assisted radical prostatectomy. BJU Int. 2011; 108(11):1874-8. DOI: 10.1111/j.1464-410X.2011.10117.x. View

19.

Leow J, Chang S, Meyer C, Wang Y, Hanske J, Sammon J . Robot-assisted Versus Open Radical Prostatectomy: A Contemporary Analysis of an All-payer Discharge Database. Eur Urol. 2016; 70(5):837-845. DOI: 10.1016/j.eururo.2016.01.044. View

20.

Gandaglia G, Sammon J, Chang S, Choueiri T, Hu J, Karakiewicz P . Comparative effectiveness of robot-assisted and open radical prostatectomy in the postdissemination era. J Clin Oncol. 2014; 32(14):1419-26. DOI: 10.1200/JCO.2013.53.5096. View