Evaluative care guideline compliance is associated with provision of benign prostatic hyperplasia surgery
- PMID: 22608799
- PMCID: PMC3392961
- DOI: 10.1016/j.urology.2012.03.011
Evaluative care guideline compliance is associated with provision of benign prostatic hyperplasia surgery
Abstract
Objective: To determine the impact of evaluative care guideline compliance on surgical intervention for benign prostatic hyperplasia (BPH).
Methods: From Medicare claims data, we developed a cohort of men new to a urologist with a diagnosis of BPH. We determined urologists' compliance with guideline recommended care (3 months) and their time- and geography-standardized average monthly Medicare expenditures (1 year). At the level of the urologist, we assessed the impact of these measures on the use of surgical therapy within 1 year of the new patient visit.
Results: Of 10 248 patients in the cohort, 675 received surgical intervention (6.7%). Guideline compliance (2% received surgery in highest quintile; 11% lowest quintile) was associated with surgical intervention. The results were robust to adjustment for patient and surgeon factors (Guideline Compliance, odds ratio = 0.09; 95% confidence interval = 0.06-0.15, highest to lowest adherence).
Conclusion: Urologists who tend to follow the AUA best practice guidelines for BPH evaluation perform surgical interventions on their BPH patients less frequently than urologists who do not follow these guidelines.
Copyright © 2012 Elsevier Inc. All rights reserved.
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References
-
- Barry MJ, Fowler FJ, Jr, O’Leary MP, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148:1549–57. discussion 1564. - PubMed
-
- Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. J Urol. 2005;173:1256–61. - PubMed
-
- Jepsen JV, Bruskewitz RC. Comprehensive patient evaluation for benign prostatic hyperplasia. Urology. 1998;51:13–8. - PubMed
-
- d’Ancona FC, Francisca EA, Hendriks JC, et al. The predictive value of baseline variables in the treatment of benign prostatic hyperplasia using high-energy transurethral microwave thermotherapy. Br J Urol. 1998;82:808–13. - PubMed
-
- Walden M, Dahlstrand C, Schafer W, et al. How to select patients suitable for transurethral microwave thermotherapy: a systematic evaluation of potentially predictive variables. Br J Urol. 1998;81:817–22. - PubMed
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