Assessing Urologist Practice Structure and Quality of Care in Prostate Cancer

A study sought to assess aspects of urologist practice structure that may affect quality of prostate cancer care. The findings were published in Urology Practice.

This study analyzed practice size, ownership of an intensity modulated radiation therapy (IMRT) device, participation within a multi-specialty group (MSG). Researchers used data from the Surveillance, Epidemiology and End-Results (SEER)-Medicare linked registry. They assessed the quality of prostate cancer treatment according to each treating urologist’s practice size, type (single-specialty vs. MSG) and ownership of IMRT, using mixed models to adjust for patient differences. Overall, 22,412 men with newly diagnosed prostate cancer treated by 2,199 urologists were included in the analysis.

The results showed minimal differences for most quality metrics according to practice size, type, and ownership of IMRT. The researchers observed that adherence to all eligible quality metrics was superior among MSGs compared to single specialty groups (20.0% adherence versus 18.2%, P = 0.01) whereas there was no significant difference by ownership of IMRT (17.1% adherence in owners versus 18.9% non-owners, P = 0.09).

“Differences in quality across practice size, type, and ownership of IMRT were modest, with substantial room for improvement regardless of practice structure,” the researchers concluded.