Risk of hospitalisation after primary treatment for prostate cancer

Stephen Williams, Zhigang Duan, Karim Chamie, Karen E. Hoffman, Benjamin D. Smith, Jim C. Hu, Jay B. Shah, John W. Davis, Sharon H. Giordano

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To compare the risk of hospitalisation and associated costs in patients after treatment for prostate cancer. Patients and Methods: We identified 29 571 patients aged 66-75 years without significant comorbidity from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database who were diagnosed with localised prostate cancer between 2004 and 2009. We compared the rates of all-cause and treatment-related hospitalisation that occurred within 365 days of the initiation of definitive therapy. We used multivariable logistic regression analysis to identify determinants associated with hospitalisation. Results: Men who underwent radical prostatectomy (RP) rather than radiotherapy (RT) had lower odds of being hospitalised for any cause after therapy [odds ratio (OR) 0.80, 95% confidence interval (CI): 0.74-0.87]. Patients who underwent RP rather than RT had higher odds of being hospitalised for treatment-related complications (OR 1.15, 95% CI: 1.03-1.29). However, men who underwent external beam RT (EBRT)/intensity modulated RT (IMRT) (OR 0.84, 95% CI: 0.72-0.99) had a 16% lower odds of hospitalisation from treatment-related complications than patients undergoing RP. Using propensity score-weighted analyses there was no significant difference in the odds of hospitalisation from treatment-related complications for men who underwent RP vs RT (OR 1.06, 95% CI: 0.92-1.21). Patients hospitalised for treatment-related complications after RT were costlier than patients who underwent RP (Mean $18 381 vs $13 203, P < 0.001). Conclusions: With the exception of men who underwent EBRT/IMRT, there was no statistically significant difference in the odds of hospitalisation from treatment-related complications. Costs from hospitalisation after treatment were significantly higher for men undergoing RT than RP. Our findings are relevant in the context of penalties linked to hospital readmissions and bundled payment models.

Original languageEnglish (US)
JournalBJU International
DOIs
StateAccepted/In press - 2016

Fingerprint

Prostatic Neoplasms
Hospitalization
Prostatectomy
Radiotherapy
Odds Ratio
Confidence Intervals
Therapeutics
Costs and Cost Analysis
Patient Readmission
Intensity-Modulated Radiotherapy
Propensity Score
Medicare
Comorbidity
Epidemiology
Logistic Models
Regression Analysis
Databases

Keywords

  • Costs
  • Hospitalisation
  • Outcomes
  • Prostate cancer
  • Treatments
  • Utilisation

ASJC Scopus subject areas

  • Urology

Cite this

Williams, S., Duan, Z., Chamie, K., Hoffman, K. E., Smith, B. D., Hu, J. C., ... Giordano, S. H. (Accepted/In press). Risk of hospitalisation after primary treatment for prostate cancer. BJU International. https://doi.org/10.1111/bju.13647

Risk of hospitalisation after primary treatment for prostate cancer. / Williams, Stephen; Duan, Zhigang; Chamie, Karim; Hoffman, Karen E.; Smith, Benjamin D.; Hu, Jim C.; Shah, Jay B.; Davis, John W.; Giordano, Sharon H.

In: BJU International, 2016.

Research output: Contribution to journalArticle

Williams, S, Duan, Z, Chamie, K, Hoffman, KE, Smith, BD, Hu, JC, Shah, JB, Davis, JW & Giordano, SH 2016, 'Risk of hospitalisation after primary treatment for prostate cancer', BJU International. https://doi.org/10.1111/bju.13647
Williams, Stephen ; Duan, Zhigang ; Chamie, Karim ; Hoffman, Karen E. ; Smith, Benjamin D. ; Hu, Jim C. ; Shah, Jay B. ; Davis, John W. ; Giordano, Sharon H. / Risk of hospitalisation after primary treatment for prostate cancer. In: BJU International. 2016.
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abstract = "Objective: To compare the risk of hospitalisation and associated costs in patients after treatment for prostate cancer. Patients and Methods: We identified 29 571 patients aged 66-75 years without significant comorbidity from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database who were diagnosed with localised prostate cancer between 2004 and 2009. We compared the rates of all-cause and treatment-related hospitalisation that occurred within 365 days of the initiation of definitive therapy. We used multivariable logistic regression analysis to identify determinants associated with hospitalisation. Results: Men who underwent radical prostatectomy (RP) rather than radiotherapy (RT) had lower odds of being hospitalised for any cause after therapy [odds ratio (OR) 0.80, 95{\%} confidence interval (CI): 0.74-0.87]. Patients who underwent RP rather than RT had higher odds of being hospitalised for treatment-related complications (OR 1.15, 95{\%} CI: 1.03-1.29). However, men who underwent external beam RT (EBRT)/intensity modulated RT (IMRT) (OR 0.84, 95{\%} CI: 0.72-0.99) had a 16{\%} lower odds of hospitalisation from treatment-related complications than patients undergoing RP. Using propensity score-weighted analyses there was no significant difference in the odds of hospitalisation from treatment-related complications for men who underwent RP vs RT (OR 1.06, 95{\%} CI: 0.92-1.21). Patients hospitalised for treatment-related complications after RT were costlier than patients who underwent RP (Mean $18 381 vs $13 203, P < 0.001). Conclusions: With the exception of men who underwent EBRT/IMRT, there was no statistically significant difference in the odds of hospitalisation from treatment-related complications. Costs from hospitalisation after treatment were significantly higher for men undergoing RT than RP. Our findings are relevant in the context of penalties linked to hospital readmissions and bundled payment models.",
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AU - Williams, Stephen

AU - Duan, Zhigang

AU - Chamie, Karim

AU - Hoffman, Karen E.

AU - Smith, Benjamin D.

AU - Hu, Jim C.

AU - Shah, Jay B.

AU - Davis, John W.

AU - Giordano, Sharon H.

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AB - Objective: To compare the risk of hospitalisation and associated costs in patients after treatment for prostate cancer. Patients and Methods: We identified 29 571 patients aged 66-75 years without significant comorbidity from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database who were diagnosed with localised prostate cancer between 2004 and 2009. We compared the rates of all-cause and treatment-related hospitalisation that occurred within 365 days of the initiation of definitive therapy. We used multivariable logistic regression analysis to identify determinants associated with hospitalisation. Results: Men who underwent radical prostatectomy (RP) rather than radiotherapy (RT) had lower odds of being hospitalised for any cause after therapy [odds ratio (OR) 0.80, 95% confidence interval (CI): 0.74-0.87]. Patients who underwent RP rather than RT had higher odds of being hospitalised for treatment-related complications (OR 1.15, 95% CI: 1.03-1.29). However, men who underwent external beam RT (EBRT)/intensity modulated RT (IMRT) (OR 0.84, 95% CI: 0.72-0.99) had a 16% lower odds of hospitalisation from treatment-related complications than patients undergoing RP. Using propensity score-weighted analyses there was no significant difference in the odds of hospitalisation from treatment-related complications for men who underwent RP vs RT (OR 1.06, 95% CI: 0.92-1.21). Patients hospitalised for treatment-related complications after RT were costlier than patients who underwent RP (Mean $18 381 vs $13 203, P < 0.001). Conclusions: With the exception of men who underwent EBRT/IMRT, there was no statistically significant difference in the odds of hospitalisation from treatment-related complications. Costs from hospitalisation after treatment were significantly higher for men undergoing RT than RP. Our findings are relevant in the context of penalties linked to hospital readmissions and bundled payment models.

KW - Costs

KW - Hospitalisation

KW - Outcomes

KW - Prostate cancer

KW - Treatments

KW - Utilisation

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