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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedMitchell JM, Gresenz CR
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Researchers examined the influence of type of practice structure, and by implication the financial incentives associated with each structure, on treatment received among men newly diagnosed with low-risk prostate cancer. They found that physician practice structure attributes were significantly associated with type of treatment received but few studies controlled for such factors. Their findings - coupled with the observation that urologist practice structure shifted substantially over this time period due to mergers of small urology groups - provided one explanation for the limited uptake of active surveillance among men with low-risk disease in the US.
AHRQ-funded; HS024972.
Citation: Mitchell JM, Gresenz CR .
The influence of practice structure on urologists' treatment of men with low-risk prostate cancer.
Med Care 2022 Sep;60(9):665-72. doi: 10.1097/mlr.0000000000001746..
Keywords: Cancer: Prostate Cancer, Cancer, Practice Patterns, Men's Health, Provider: Physician
Mitchell JM, Gresenz CR
Documenting horizontal integration among urologists who treat prostate cancer.
The purpose of this study was to create and employ a methodology to document changes in physician practice structure resulting from horizontal mergers among urology groups. To identify all urologists who treated men with prostate cancer, the researchers integrated cancer registry records from four large states with Medicare Part B claims. Information from SK & A surveys and extensive internet searches was added to assign a practice structure to each urologist-year from 2005-2014. The study found that horizontal merging among small urology groups resulted in a strong increase in the percentage of urologists who belong to large urology practices with ownership in anatomical pathology services and/or intensity modulated radiation therapy. By 2014, small percentages (7%-16%) of New Jersey, Florida and Texas urologists were employed by a health system, whereas more than half of New Jersey urologists and about 43% of urologists in Florida and Texas were members of large practices. This is compared to California urologists of which only 17.5% had ownership in intensity modulated radiation therapy and/or pathology services. The researchers highlighted that the study indicators of market share of urologists connected with each practice structure type were highly correlated with indicators of market share based on quantity of prostate cancer events treated by each type of practice structure.
AHRQ-funded; HS024972.
Citation: Mitchell JM, Gresenz CR .
Documenting horizontal integration among urologists who treat prostate cancer.
Med Care Res Rev 2022 Feb;79(1):141-50. doi: 10.1177/1077558720980552..
Keywords: Cancer: Prostate Cancer, Cancer, Provider: Physician