Document Detail

Evaluative care guideline compliance is associated with provision of benign prostatic hyperplasia surgery.
MedLine Citation:
PMID:  22608799     Owner:  NLM     Status:  MEDLINE    
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.
Seth A Strope; John T Wei; Alexandria Smith; Timothy J Wilt; Christopher S Saigal; Sean P Elliott;
Related Documents :
24461049 - Surgical quality is more than volume: the association between changing urologists and c...
22460399 - Posterior spinal fusion from t2 to the sacrum for the management of major deformities i...
22885639 - A large primary vaginal calculus in a woman with paraplegia.
23008929 - Post-traumatic synchronous twin inter-muscular abdominal and diaphragmatic hernias: a r...
22453709 - Conservative approach to the management of morbidly adherent placentae.
22430299 - Complications and outcome after laparoscopic bariatric surgery: lagb versus lrygb.
15142139 - Male genital injury: diagnostics and treatment.
15576209 - Surgical treatment of macrodactyly in older children and adults.
10929719 - Combined management of intracranial aneurysms by surgical and endovascular treatment. m...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-05-18
Journal Detail:
Title:  Urology     Volume:  80     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-03     Completed Date:  2012-09-17     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  84-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Guideline Adherence / statistics & numerical data*
Prostatic Hyperplasia / surgery*
Urologic Surgical Procedures, Male / standards,  statistics & numerical data
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Psychometric Characteristics of a Condition-specific, Health-related Quality-of-life Survey: The FAC...
Next Document:  Safety and Efficacy of a Novel Ureteral Occlusion Device.