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To identify physician-level factors associated with high rates of sacral neuromodulation testing.We performed a retrospective cohort study using a 20% sample of national Medicare claims to identify physicians who performed sacral neuromodulation procedures between 2005 and 2010. Physician-level rates of device testing were determined based on the number of patients seen for overactive bladder and...
To evaluate the association of technological capacity with prostate cancer quality of care. Technological capacity was conceptualized as a market's ability to provide prostate cancer treatment with new technology, including robotic prostatectomy and intensity-modulated radiotherapy (IMRT).In this retrospective cohort study, we used data from the Surveillance, Epidemiology, and End Results–Medicare...
To determine the effect of an ambulatory surgery center (ASC) opening in a healthcare market on utilization and quality of outpatient urologic surgery.This is a retrospective cohort study of Medicare beneficiaries undergoing outpatient urologic surgery from 2001 to 2010. Markets were classified into 3 groups based on ASC status (ie, those with ASCs, those without ASCs, and those where ASCs were introduced)...
To better understand associations between managed care penetration in health care markets and the adoption of intensity-modulated radiotherapy (IMRT).We used Surveillance, Epidemiology, and End Results–Medicare data to identify men diagnosed with prostate cancer between 2001 and 2007 who were treated with radiotherapy (n = 55,162). We categorized managed care penetration in Health Service Areas (HSAs)...
To better understand the associations between the certificate of need regulations and intensity-modulated radiotherapy dissemination. Using Surveillance, Epidemiology, and End Results-Medicare data, we identified men (aged ≥66 years) treated with radiotherapy for prostate cancer who had been diagnosed from 2001 to 2007. Using data from the American Health Planning Association, we sorted the health...
To better inform avenues for improving the quality of bladder cancer care, we evaluated whether the variation in pelvic lymph node dissection during radical cystectomy was primarily due to the patient or the surgeon. In the clinical guidelines, pelvic lymph node dissection has been recommended as an adjunct to radical cystectomy. However, its use and extent have varied across providers and regions...
To understand whether growth in prostate cancer spending is a result of selected use of expensive services or greater overall usage. Growth in prostate cancer spending continues to outpace that for overall health expenditures, garnering nearly $7 billion annually. We identified patients diagnosed with prostate cancer between January 1, 1992 and December 31, 2003 using Surveillance, Epidemiology,...
For radical prostatectomy, the advantages of robotic surgery may facilitate precise dissection and improve functional outcomes. However, patients with larger prostates may still pose increased challenges because of impaired visualization and mobility in the pelvis. For this reason, we undertook a study to better understand the relationships between large prostate size and robotic prostatectomy outcomes...
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