alexa Racial disparities in changing to a high-volume urologist among men with localized prostate cancer.
Oncology

Oncology

Journal of Prostate Cancer

Author(s): Pollack CE, Bekelman JE, Epstein AJ, Liao K, Wong YN, , Pollack CE, Bekelman JE, Epstein AJ, Liao K, Wong YN,

Abstract Share this page

Abstract BACKGROUND: Patients who receive surgery from high-volume surgeons tend to have better outcomes. Black patients, however, are less likely to receive surgery from high-volume surgeons. OBJECTIVE: Among men with localized prostate cancer, we examined whether disparities in use of high-volume urologists resulted from racial differences in patients being diagnosed by high-volume urologists and/or changing to high-volume urologists for surgery. RESEARCH DESIGN: Retrospective cohort study from Surveillance, Epidemiology, and End Results-Medicare data. SUBJECTS: A total of 26,058 black and white men in Surveillance, Epidemiology, and End Results-Medicare diagnosed with localized prostate cancer from 1995 to 2005 that underwent prostatectomy. Patients were linked to their diagnosing urologist and a treating urologist (who performed the surgery). MEASURES: Diagnosis and receipt of prostatectomy by a high-volume urologist, and changing between diagnosing and treating urologist RESULTS: After adjustment for confounders, black men were as likely as white men to be diagnosed by a high-volume urologist; however, they were significantly less likely than white men to be treated by a high-volume urologist [odds ratio 0.76; 95\% confidence interval (CI), 0.67-0.87]. For men diagnosed by a low-volume urologist, 46.0\% changed urologists for their surgery. Black men were significantly less likely to change to a high-volume urologist (relative risk ratio 0.61; 95\% CI, 0.47-0.79). Racial differences appeared to reflect black and white patients being diagnosed by different urologists and having different rates of changing after being diagnosed by the same urologists. CONCLUSIONS: Lower rates of changing to high-volume urologists for surgery among black men contribute to racial disparities in treatment by high-volume surgeons.
This article was published in Med Care and referenced in Journal of Prostate Cancer

Relevant Expert PPTs

Relevant Speaker PPTs

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords