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BMC Urology
Published in: BMC Urology 1/2017

Open Access 01-12-2017 | Research article

Patient driven care in the management of prostate cancer: analysis of the United States military healthcare system

Authors: Muhammad Ali Chaudhary, Jeffrey J. Leow, Matthew Mossanen, Ritam Chowdhury, Wei Jiang, Peter A. Learn, Joel S. Weissman, Steven L. Chang

Published in: BMC Urology | Issue 1/2017

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Abstract

Background

Patient preferences are assumed to impact healthcare resource utilization, especially treatment options. There is limited data exploring this phenomenon. We sought to identify factors associated with patients transferring care for prostatectomy, from military to civilian facilities, and the receipt of minimally invasive radical prostatectomy (MIRP).

Methods

Retrospective review of 2006-2010 TRICARE data identified men diagnosed with prostate cancer (ICD-9 185) receiving open radical prostatectomy (ORP; ICD-9: 60.5) or MIRP (ICD-9 60.5 + 54.21/17.42). Patients diagnosed at military facilities but underwent surgery at civilian facilities were defined as “transferring care”. Logistic regression models identified predictors of transferring care for patients diagnosed at military facilities. A secondary analysis identified the predictors of MIRP receipt at civilian facilities.

Results

Of 1420 patients, 247 (17.4%) transferred care. These patients were more likely to undergo MIRP (OR = 7.83, p < 0.01), and get diagnosed at low-volume military facilities (OR = 6.10, p < 0.01). Our secondary analysis demonstrated that transferring care was strongly associated with undergoing MIRP (OR = 1.51, p = 0.04).

Conclusions

Patient preferences induced a demand for greater utilization of MIRP and civilian facilities. Further work exploring factors driving these preferences and interventions tailoring them, based on evidence and cost considerations, is required.
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Metadata
Title
Patient driven care in the management of prostate cancer: analysis of the United States military healthcare system
Authors
Muhammad Ali Chaudhary
Jeffrey J. Leow
Matthew Mossanen
Ritam Chowdhury
Wei Jiang
Peter A. Learn
Joel S. Weissman
Steven L. Chang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2017
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-017-0247-x

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