Integrated PCa Care Improves IMRT Efficiency
Converting Urology Practice Affects Cancer Treatment
Converting a urology practice to an integrated prostate cancer center (IPCC) results in greater use of intensity modulated radiation therapy and lower use of androgen deprivation therapy, according to research published in The Journal of Urology.
To examine the impact of converting a urology practice to an IPCC in July 2006 on prostate cancer treatment patterns, Justin E. Bekelman, M.D., from the University of Pennsylvania in Philadelphia, and colleagues used the Statistics, Epidemiology and End Results-Medicare database to identify men 65 years and older diagnosed with non-metastatic prostate cancer in one state from 2004 to 2007. Patients were classified into three groups: those seen by IPCC physicians, those living in the same hospital referral region but not seen by IPCC physicians, and those living elsewhere in the state.
The researchers found that after the conversion to an IPCC the adjusted use of intensity modulated radiation therapy increased by 20.3 ppts for patients seen by IPCC physicians, by 19.2 ppts for patients in the hospital referral region group, and by 8.1 ppts in the state group. In contrast, androgen deprivation therapy, the reimbursement of which by Medicare fell sharply, decreased in both the IPCC and hospital referral groups. The IPCC group also had a significant drop in prostatectomy.
"Our findings suggest that multispecialty consolidation of prostate cancer care without accompanying payment reform may be associated with market wide changes in practice patterns," Bekelman and colleagues conclude.