Geographic Variations in Prostatectomy Rates: The Impact of Variations in Case Rates and At-Risk Surgery Rates. Executive Summary and Final Report

摘要

The study analyzed geographic variation in prostatectomy surgery rates in California. Medicare data were used to identify patients who consulted a urologist of benign prostate disease (BPH). The population-based surgery rate was segmented into the rate of consultation for BPH (the 'case rate'), and the surgery rate among patients with urologist-diagnosed BPH (the 'at-risk' rate). Results showed that each rate had significant geographic variability. Case rate variation contributed significantly to population-based surgery rate variation over and above the contribution of the at-risk surgery rate. The case rate was significantly positively associated with the number of urologists and the area unemployment rate. The at-risk rate was significantly positively associated with the area rate of public assistance and significantly negatively associated with the average number of prostate patients per urologist. In conclusion, variation in the population-based surgery rate is a result of variation in both the case rate and the at-risk surgery rate.