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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 2 of 2 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
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