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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 6 of 6 Research Studies DisplayedTallman JE, Wallis CJD, Zhao Z
Prostate volume, baseline urinary function, and their association with treatment choice and post-treatment urinary function in men treated for localized prostate cancer.
The purpose of this study was to assess the relationship between prostate volume (PV) and baseline urinary function with treatment choice and post-treatment urinary function among men with localized prostate cancer. The researchers identified 1,647 patients from CEASAR, a multicenter population-based, prospective cohort study of men with localized prostate cancer. The primary study outcomes were treatment choice and health-related quality of life (HRQOL) assessed at pre-specified intervals up to 5 years. The study found that median baseline PV was 36 mL (IQR 27-48), and baseline urinary irritative/obstructive domain score was 87 (IQR 75-100). The study did not find any observed clinically meaningful relationship between PV and treatment choice or post-treatment urinary function. In participants with poor baseline urinary function, treatment with radiation or surgery was related with statistically and clinically significant improvement in urinary function at 6 months which endured through 5 years.
AHRQ-funded; HS019356; HS022640.
Citation: Tallman JE, Wallis CJD, Zhao Z .
Prostate volume, baseline urinary function, and their association with treatment choice and post-treatment urinary function in men treated for localized prostate cancer.
Prostate Cancer Prostatic Dis 2023 Dec; 26(4):787-94. doi: 10.1038/s41391-022-00627-1..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health
Jayadevappa R, Malkowicz SB, Vapiwala N
Association between hospital competition and quality of prostate cancer care.
The purpose of this retrospective study was to explore the relationship between hospital competition and outcomes in elderly with localized prostate cancer (PCa). The researchers also evaluated whether race moderated the relationship. The researchers applied the Hirschman-Herfindahl index (HHI) to measure hospital competition. The study outcomes were emergency room (ER) visits, hospitalizations, Medicare expenditure and mortality assessed in acute survivorship phase (two years post-PCa diagnosis), and long-term mortality. The study found that among 253,176 patients, percent change in incident rate of ER visit was 17% higher for one unit increase in HHI. Incident rate of ER was 24% higher for whites and 48% higher for African Americans. For one unit increase in HHI, hazard of short-term all-cause mortality was 7% higher for whites and 11% lower for African Americans. The hazard of long-term all-cause mortality was 10% higher for whites and 13% higher for African Americans.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Malkowicz SB, Vapiwala N .
Association between hospital competition and quality of prostate cancer care.
BMC Health Serv Res 2023 Aug 5; 23(1):828. doi: 10.1186/s12913-023-09851-4..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Hospitals, Quality of Care
Hill D, Kaufman SR, Oerline MK
In-office dispensing of oral targeted agents by urology practices in men with advanced prostate cancer.
Researchers investigated the dispensing oral targeted agents for advanced prostate cancer treatment directly to patients in urologists’ offices, and whether this delivery model improves access to these agents especially for Black men who are historically undertreated. Their retrospective cohort study used national Medicare data for men with advanced prostate cancer managed by urology practices with and without in-office dispensing. They concluded that this model of delivery could improve access to this class of medications.
AHRQ-funded; HS025707.
Citation: Hill D, Kaufman SR, Oerline MK .
In-office dispensing of oral targeted agents by urology practices in men with advanced prostate cancer.
JNCI Cancer Spectr 2023 Jul 3; 7(5). doi: 10.1093/jncics/pkad062..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Medication
Jayadevappa R, Guzzo T, Vapiwala N
Continuity of care and advanced prostate cancer.
This study’s objective was to assess the association of provider continuity of care with outcomes among Medicare fee-for-service beneficiaries with advanced prostate cancer and its variation by race. This retrospective study used SEER-Medicare data of African American and white Medicare beneficiaries aged 66 or older and diagnosed with advanced prostate cancer between 2000 and 2011. The authors used at least 5 years of follow-up data. Short-term outcomes examined were emergency room (ER) visits, hospitalizations, and cost during acute survivorship phase (2-year post-diagnosis), and mortality (all-cause and prostate cancer-specific) during the follow-up period. They calculated continuity of care using Continuity of Care Index (COCI) and Usual Provider Care Index (UPCI), for all visits, oncology visits, and primary care visits in acute survivorship phase. They performed similar analysis for continuity of care in the 2-year period following acute survivorship phase. They found that a one unit increase in COCI was associated with reduction in short-term ER visits (incidence rate ratio [IRR] = 0.65), hospitalizations (IRR = 0.65), and cost (0.64) and lower hazard of long-term mortality. The benefits of higher continuity of care were greater for African Americans than white patients.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Guzzo T, Vapiwala N .
Continuity of care and advanced prostate cancer.
Cancer Med 2023 May; 12(10):11795-805. doi: 10.1002/cam4.5845..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Medicare
Agochukwu-Mmonu N, Qin Y, Kaufman S
Understanding the role of urology practice organization and racial composition in prostate cancer treatment disparities.
This study examined the associations between urology practice organization and racial composition and treatment patterns for Medicare beneficiaries with incident prostate cancer. The authors used a 20% sample of national Medicare data to identify beneficiaries diagnosed with prostate cancer between January 2010 and December 2015 and followed them through 2016. They then linked urologists to their practices with tax identification numbers and patients to their practices based on their primary urologist. They identified 54,443 patients with incident prostate cancer, with most (87%) White and 9% Black. They found wide variation in racial practice composition and practice segregation. Patients in practices with the highest proportion of Black patients had the lowest socioeconomic status (43.1%), highest comorbidity (9.9% with comorbidity score ≥ 3), and earlier age at prostate cancer diagnosis (33.5% age 66-69 years). Black patients had lower odds of definitive therapy and underwent less treatment than White patients in every practice context. Black patients had lower predicted probability of treatment (66%) than White patients (69%).
AHRQ-funded; HS025707.
Citation: Agochukwu-Mmonu N, Qin Y, Kaufman S .
Understanding the role of urology practice organization and racial composition in prostate cancer treatment disparities.
JCO Oncol Pract 2023 May; 19(5):e763-e72. doi: 10.1200/op.22.00147..
Keywords: Cancer: Prostate Cancer, Cancer, Men's Health, Disparities, Racial and Ethnic Minorities
Fitzgibbons Jr RJ, Ramanan B, Arya S
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
This study of 254 men with minimally symptomatic inguinal hernia who were assigned to watchful waiting (WW) found that WW is a reasonable and safe strategy. However, the study which followed these patients for up to 11.5 years found that symptoms usually progressed and an operation was eventually needed, with 79 percent of men older than 65 and 62 percent of younger men receiving surgical repair.
AHRQ-funded; HS09860
Citation: Fitzgibbons Jr RJ, Ramanan B, Arya S .
Long-term results of a randomized controlled trial of a nonoperative strategy (watchful waiting) for men with minimally symptomatic inguinal hernias.
Ann Surg. 2013 Sep;258(3):508-15. doi: 10.1097/SLA.0b013e3182a19725..
Keywords: Surgery, Men's Health, Quality of Care, Patient Safety, Shared Decision Making