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AHRQ Research Studies
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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 10 of 10 Research Studies DisplayedJayadevappa 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
Caram MEV, Oerline MK, Dusetzina S
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
The authors investigated coping and material measures of the financial hardship of abiraterone and enzalutamide among patients with advanced prostate cancer with Medicare Part D coverage. They found substantial variations in the adherence rate and out-of-pocket payments, with sociodemographic patient and regional factors found to be associated with both aspects.
AHRQ-funded; HS025707.
Citation: Caram MEV, Oerline MK, Dusetzina S .
Adherence and out-of-pocket costs among Medicare beneficiaries who are prescribed oral targeted therapies for advanced prostate cancer.
Cancer 2020 Dec 1;126(23):5050-59. doi: 10.1002/cncr.33176..
Keywords: Patient Adherence/Compliance, Medicare, Cancer: Prostate Cancer, Cancer, Medication, Healthcare Costs
Modi PK, Kaufman SR, Qi J
National trends in active surveillance for prostate cancer: validation of medicare claims-based algorithms.
This study analyzed the use of active surveillance of low-risk prostate cancer among a wide variety of health care practices. Researchers identified men with prostate cancer from 2012-2014 using a 100% sample of Michigan Medicare data and linked them with the Michigan Urologic Surgery Improvement Collaborative (MUSIC) registry. They analyzed the performance of 8 claims-based algorithms that were used and selected 3 of them to apply to a 20% national Medicare sample. The 3 algorithms were determined to be either the most sensitive, the most specific, and a balanced algorithm incorporating age and comorbidity. They found that use of surveillance for men increased from 2007 to 2014 but there was a large decrease in the rate of prostate cancer diagnosis. The rate of active surveillance either increased or remained stable depending on the algorithm used.
AHRQ-funded; HS025707.
Citation: Modi PK, Kaufman SR, Qi J .
National trends in active surveillance for prostate cancer: validation of medicare claims-based algorithms.
Urology 2018 Oct;120:96-102. doi: 10.1016/j.urology.2018.06.037..
Keywords: Cancer, Cancer: Prostate Cancer, Medicare, Men's Health, Payment
Modi PK, Kaufman SR, Borza T
Variation in prostate cancer treatment and spending among Medicare shared savings program accountable care organizations.
This study assessed whether the level of engagement in accountable care organizations (ACOs) by urologists affected rates of treatment, overtreatment, and spending. The investigators found that ACOs vary widely in treatment, potential overtreatment, and spending for prostate cancer. ACOs with stronger urologist engagement were less likely to treat men with a high risk of noncancer mortality, and this suggests that organizations that better engage specialists may be able to improve the value of specialty care.
AHRQ-funded; HS024728; HS025707; HS024525.
Citation: Modi PK, Kaufman SR, Borza T .
Variation in prostate cancer treatment and spending among Medicare shared savings program accountable care organizations.
Cancer 2018 Aug;124(16):3364-71. doi: 10.1002/cncr.31573..
Keywords: Cancer: Prostate Cancer, Healthcare Costs, Healthcare Utilization, Medicare
Borza T, Kaufman SR, Yan P
Early effect of Medicare Shared Savings Program accountable care organization participation on prostate cancer care.
The purpose of this study was to understand the effect of Medicare Shared Savings Program accountable care organizations (ACOs) on prostate cancer care. The authors found that the treatment of prostate cancer and annual payments decreased significantly between 2010 and 2013, but ACO participation did not appear to impact these trends. Among men least likely to benefit, Medicare Shared Savings Program ACO alignment was associated with a significant decline in prostate cancer treatment.
AHRQ-funded; HS024728; HS024525.
Citation: Borza T, Kaufman SR, Yan P .
Early effect of Medicare Shared Savings Program accountable care organization participation on prostate cancer care.
Cancer 2018 Feb 1;124(3):563-70. doi: 10.1002/cncr.31081..
Keywords: Cancer: Prostate Cancer, Healthcare Costs, Medicare
Raval AD, Mattes MD, Madhavan S
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
The researchers examined the association between metformin use and cancer stage at diagnosis among elderly men with preexisting diabetes mellitus and incident prostate cancer. They found a significantly lower percentage of metformin users were diagnosed with advanced prostate cancer as compared to nonusers (4.7 percent versus 6.7 percent.
AHRQ-funded; HS018622.
Citation: Raval AD, Mattes MD, Madhavan S .
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
J Diabetes Res 2016;2016:2656814. doi: 10.1155/2016/2656814.
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Keywords: Cancer: Prostate Cancer, Medication, Elderly, Diabetes, Medicare
Raval AD, Madhavan S, Mattes MD
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
The current retrospective observational study was conducted to examine the association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer. It found that those with none of the 3 types of chronic conditions (cardiometabolic, mental health, and respiratory) were 44 percent more likely to be diagnosed with advanced prostate cancer compared to men with all 3 types of chronic conditions.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
Popul Health Manag 2016 Dec;19(6):445-53. doi: 10.1089/pop.2015.0141.
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Keywords: Cancer, Cancer: Prostate Cancer, Elderly, Medicare
Jayadevappa R, Chhatre S
Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer.
The authors analyzed the association between age, substance use, and outcomes in fee-for-service Medicare enrollees with advanced prostate cancer. As they found age-specific results, they recommend an integrated and multidisciplinary approach to screen, refer, and treat substance use in patients with prostate cancer to improve outcomes and reduce costs.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S .
Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer.
J Geriatr Oncol 2016 Nov;7(6):444-52. doi: 10.1016/j.jgo.2016.06.007.
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Keywords: Elderly, Medicare, Outcomes, Cancer: Prostate Cancer, Substance Abuse
Raval AD, Madhavan S, Mattes MD
Impact of prostate cancer diagnosis on noncancer hospitalizations among elderly Medicare Beneficiaries with incident prostate cancer.
The authors analyzed the impact of cancer diagnosis on noncancer hospitalizations (NCHs) by comparing these hospitalizations between the precancer and postcancer periods. They found that the rate of NCHs was higher during the postcancer period compared with the precancer period. They suggested that their study highlights the need to design interventions for reducing the excess NCHs after prostate cancer diagnosis among elderly men.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Impact of prostate cancer diagnosis on noncancer hospitalizations among elderly Medicare Beneficiaries with incident prostate cancer.
J Natl Compr Canc Netw 2016 Feb;14(2):186-94.
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Keywords: Elderly, Hospitalization, Medicare, Cancer: Prostate Cancer
Zanwar P, Lin YL, Kuo YF
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort
The investigators assessed the tests, treatments, and payments for prostate cancer care in men aged 75 or older who have primary care physicians (PCPs) with high or low prostate specific antigen (PSA) testing rates. They found that older men seeing PCPs with high rates of PSA testing undergo more testing and treatments for prostate cancer, with higher Medicare insurance payments.
AHRQ-funded; HS022134.
Citation: Zanwar P, Lin YL, Kuo YF .
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort
BMC Health Serv Res 2016 Jan 15;16:17. doi: 10.1186/s12913-016-1265-1.
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Keywords: Elderly, Medicare, Primary Care, Cancer: Prostate Cancer, Screening