Document Detail


Evaluative care guideline compliance is associated with provision of benign prostatic hyperplasia surgery.
MedLine Citation:
PMID:  22608799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Seth A Strope; John T Wei; Alexandria Smith; Timothy J Wilt; Christopher S Saigal; Sean P Elliott;
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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.
Affiliation:
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. stropes@wudosis.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Guideline Adherence / statistics & numerical data*
Humans
Male
Prostatic Hyperplasia / surgery*
Urologic Surgical Procedures, Male / standards,  statistics & numerical data
Urology*
Grant Support
ID/Acronym/Agency:
KL2 RR024994/RR/NCRR NIH HHS; N01 DK012460/DK/NIDDK NIH HHS; N01-DK-1-2460/DK/NIDDK NIH HHS
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