Table 1.
Adherence to quality measures stratified by demographics and clinical characteristics of the study population. Quality measures: (1) proportion of patients seen by both a urologist and a radiation oncologist between diagnosis and start of treatment (“seen both”), (2) proportion of patients with low-risk cancer avoiding receipt of a non-indicated bone scan (only patients diagnosed 2004–2007 included, “bone scan”), (3) proportion of patients with high-risk cancer receiving adjuvant androgen deprivation therapy while undergoing radiotherapy (only patients diagnosed 2004–2007 included, “adjuvant ADT”), (4) proportion of patients treated by a high volume provider (“high-volume provider”), (5a) proportion of patients having at least two follow-up visits with a treating radiation oncologist (“f/u with radonc”), (5b) proportion of patients having at least two follow-up visits with a treating urologist (“f/u with urologist”).
Abbreviations: radonc: radiation oncologist; nr: not reported because of low numbers (<100) in the denominator; na: not applicable
| Characteristics | N | % of patients receiving care adherent to quality measure | |||||
|---|---|---|---|---|---|---|---|
| (1) seen both | (2) bone scan | (3) adjuvant ADT | (4) high-volume provider | (5a) f/u with radonc | (5b) f/u with urologist | ||
| Overall | 53,614 | 51.2 | 65.9 | 76.8 | 32.9 | 53.4 | 66.3 |
| Patient characteristics | |||||||
| Age, years | |||||||
| 66–69 | 17,768 | 40.9* | 68.5* | 72.6* | 32.4 | 55.9* | 65.5 |
| 70–74 | 19,656 | 51.9* | 65.3* | 75.6* | 33.1 | 54.6* | 67.7 |
| 75–79 | 11,984 | 61.1* | 63.8* | 77.9* | 33.4 | 52.1* | 68.7 |
| 80–84 | 3,599 | 63.9* | 58.4* | 81.2* | 32.7 | 47.3* | nr |
| 85+ | 607 | 58.5* | 68.4* | 88.4* | 29.9 | 40.1* | nr |
| Race/ethnicity | |||||||
| White | 45,796 | 51.6** | 66.5** | 76.4 | 33.2** | 53.9** | 65.7 |
| Black | 3,857 | 47.4** | 60.5** | 77.7 | 32.9** | 52.4** | 71.7 |
| Hispanic | 1,042 | 47.8** | 63.7** | 83.5 | 23.3** | 49.4** | 70.2 |
| Asian | 1,492 | 50.0** | 70.6** | 80.0 | 31.5** | 48.8** | 69.8 |
| Other/unknown | 1,427 | 50.2** | 58.6** | 78.0 | 32.4** | 47.1** | 67.9 |
| Comorbidity | |||||||
| 0 | 36,873 | 49.7* | 67.2* | 76.4 | 33.1 | 54.0* | 65.6 |
| 1 | 11,567 | 53.7* | 63.7* | 76.8 | 32.5 | 53.6* | 69.3 |
| 2 | 3,383 | 54.4* | 63.2* | 79.0 | 33.2 | 49.5* | 68.9 |
| 3+ | 1,791 | 58.6* | 57.9* | 77.6 | 30.7 | 48.1* | 60.1 |
| Clinical stage | |||||||
| T1 | 25,902 | 50.6* | 66.1 | 80.3 | 35.3* | 54.6* | 65.1 |
| T2 | 26,138 | 51.4* | 65.3 | 72.5 | 31.1* | 52.9* | 67.8 |
| T3 | 1,328 | 61.8* | na | 90.0 | 23.3* | 42.4* | 64.0 |
| T4 | 159 | 54.1* | na | 92.4 | 20.1* | 34.3* | nr |
| Tumor grade | |||||||
| Well/moderately differentiated | 30,436 | 51.6 | 66.2** | 54.2** | 33.0 | 55.7** | 67.2 |
| Poorly/undifferentiated | 22,661 | 50.6 | 56.0** | 82.5** | 32.9 | 49.7** | 65.3 |
| Unknown | 517 | 51.3 | na | na | 26.9 | 59.4** | nr |
| D'Amico risk (2004–2007) | |||||||
| Low | 8,944 | 53.7 | 65.9 | na | 38.2* | 57.2* | 62.3 |
| Intermediate | 10,525 | 50.4 | na | na | 37.2* | 51.9* | 63.2 |
| High | 8,468 | 55.6 | na | 76.8 | 32.1* | 48.9* | 64.5 |
| Missing | 3,296 | 43.7 | na | na | 33.1* | 54.2* | 66.1 |
| Year of diagnosis | |||||||
| 2001 | 7,256 | 46.3* | na | na | 22.8* | 52.2 | 70.6* |
| 2002 | 7,745 | 51.5* | na | na | 31.6* | 54.6 | 70.5* |
| 2003 | 7,380 | 51.9* | na | na | 32.3* | 55.1 | 69.8* |
| 2004 | 7,735 | 51.3* | 66.7 | 79.0 | 33.3* | 54.4 | 67.6* |
| 2005 | 7,426 | 52.4* | 66.5 | 73.9 | 33.8* | 51.5 | 65.3* |
| 2006 | 7,932 | 53.0* | 65.1 | 77.2 | 37.0* | 53.5 | 62.0* |
| 2007 | 8,140 | 51.6* | 65.4 | 76.9 | 38.5* | 52.2 | 60.5* |
| Socioeconomic status14 | |||||||
| Low | 16,042 | 47.7* | 63.3* | 75.4 | 28.1* | 51.9* | 67.4 |
| Medium | 17,821 | 53.7* | 66.7* | 78.2 | 32.8* | 52.7* | 67.0 |
| High | 18,668 | 51.9* | 67.2* | 76.7 | 37.0* | 55.3* | 65.0 |
| Residing in urban area | |||||||
| non-urban | 5,063 | 49.8 | 62.9 | 74.9 | 25.8* | 45.8* | 61.7* |
| urban | 48,544 | 51.3 | 66.1 | 77.0 | 33.6* | 54.2* | 66.8* |
| Regional characteristics | |||||||
| Urologists per 100,000 men | |||||||
| Low (≤ 53) | 16,848 | 50.9 | 69.0* | 76.5 | 29.2* | 52.6* | 65.9 |
| Intermediate | 16,647 | 52.1 | 67.1* | 77.3 | 32.3* | 51.3* | 67.4 |
| High (≥ 87) | 20,112 | 50.7 | 62.4* | 76.6 | 36.5* | 55.6* | 65.7 |
| Radiation oncologists per 100,000 men | |||||||
| Low (≤ 21) | 17,449 | 50.3 | 66.7 | 76.4 | 33.1 | 53.0* | 65.0* |
| Intermediate | 17,132 | 54.5 | 66.5 | 77.4 | 31.7 | 51.4* | 65.2* |
| High (≥ 37) | 19,026 | 49.1 | 64.7 | 76.6 | 33.8 | 55.5* | 68.4* |
| Hospital beds per 100,000 men | |||||||
| Low (≤ 4,735) | 16,975 | 51.5* | 70.6* | 76.3 | 30.6 | 51.2 | 67.1 |
| Intermediate | 18,544 | 55.3* | 64.8* | 77.6 | 38.1 | 55.7 | 63.4 |
| High (≥ 6,854) | 18,088 | 46.7* | 62.5* | 76.4 | 29.6 | 52.9 | 68.0 |
| Medicare Managed Care Penetration | |||||||
| Low (≤ 5.1%) | 16,284 | 53.9* | 66.9* | 77.9* | 24.9* | 51.6 | 65.0 |
| Intermediate | 19,327 | 53.0* | 60.5* | 79.2* | 44.0* | 57.9 | 68.8 |
| High (≥ 19.4%) | 17,996 | 46.8* | 71.1* | 73.7* | 28.0* | 49.5 | 65.5 |
p≤0.001, Mantel-Haenszel chi square test
p≤0.001, chi square test