Utilization trends at a multidisciplinary prostate cancer clinic

Initial 5-year experience from the duke prostate center

Suzanne Merrill, Lionel L. Baez, Cary N. Robertson, Stephen J. Freedland, Thomas J. Polascik, Donghua Xie, Bridget F. Koontz, Zeljko Vujaskovic, W. Robert Lee, Andrew J. Armstrong, Phillip G. Febbo, Daniel J. George, Judd W. Moul

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: The multidisciplinary approach is becoming increasingly encouraged but little is known about the multidisciplinary experience compared to routine care. For patients with prostate cancer the goal is to provide evaluations by urologists, medical and radiation oncologists at a single visit. Although additional resources are required, this strategy may enhance the overall health care experience. We compared utilization determinants between a multidisciplinary and a urology prostate cancer clinic at Duke University Medical Center and identified factors associated with pursuing treatment at the university medical center for multidisciplinary clinic patients. Materials and Methods: We retrospectively analyzed data on patients referred for primary prostate cancer treatment evaluation at Duke University Medical Center from 2005 to 2009. Comparisons between 701 multidisciplinary clinic and 1,318 urology prostate cancer clinic patients were examined with the rank sum and chi-square tests. Predictive factors for pursuing treatment at the university medical center were assessed using multivariate adjusted logistic regression. Results: Compared to patients at the urology prostate cancer clinic those at the multidisciplinary clinic were more likely to be younger and white, have a higher income and travel a longer distance for evaluation. Of multidisciplinary clinic patients 58% pursued primary treatment at the university medical center. They were more likely to be younger, black and physician referred, have a lower income and reside closer to the medical center. Factors predictive of pursuing treatment at the medical center included high risk disease and physician referral. Factors predictive of not receiving care at the university medical center were income greater than $40,000 and a distance traveled of greater than 100 miles. Conclusions: A different patient demographic is using the multidisciplinary approach. However, when treatment is pursued at the institution providing multidisciplinary services, the patient demographic resembles that of the treating institution.

Original languageEnglish (US)
Pages (from-to)103-108
Number of pages6
JournalJournal of Urology
Volume187
Issue number1
DOIs
StatePublished - Jan 1 2012

Fingerprint

Prostate
Prostatic Neoplasms
Urology
Therapeutics
Demography
Physicians
Chi-Square Distribution
Referral and Consultation
Logistic Models
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Merrill, Suzanne ; Baez, Lionel L. ; Robertson, Cary N. ; Freedland, Stephen J. ; Polascik, Thomas J. ; Xie, Donghua ; Koontz, Bridget F. ; Vujaskovic, Zeljko ; Lee, W. Robert ; Armstrong, Andrew J. ; Febbo, Phillip G. ; George, Daniel J. ; Moul, Judd W. / Utilization trends at a multidisciplinary prostate cancer clinic : Initial 5-year experience from the duke prostate center. In: Journal of Urology. 2012 ; Vol. 187, No. 1. pp. 103-108.
@article{665fb4aae9c24169a4a56658d87cefc7,
title = "Utilization trends at a multidisciplinary prostate cancer clinic: Initial 5-year experience from the duke prostate center",
abstract = "Purpose: The multidisciplinary approach is becoming increasingly encouraged but little is known about the multidisciplinary experience compared to routine care. For patients with prostate cancer the goal is to provide evaluations by urologists, medical and radiation oncologists at a single visit. Although additional resources are required, this strategy may enhance the overall health care experience. We compared utilization determinants between a multidisciplinary and a urology prostate cancer clinic at Duke University Medical Center and identified factors associated with pursuing treatment at the university medical center for multidisciplinary clinic patients. Materials and Methods: We retrospectively analyzed data on patients referred for primary prostate cancer treatment evaluation at Duke University Medical Center from 2005 to 2009. Comparisons between 701 multidisciplinary clinic and 1,318 urology prostate cancer clinic patients were examined with the rank sum and chi-square tests. Predictive factors for pursuing treatment at the university medical center were assessed using multivariate adjusted logistic regression. Results: Compared to patients at the urology prostate cancer clinic those at the multidisciplinary clinic were more likely to be younger and white, have a higher income and travel a longer distance for evaluation. Of multidisciplinary clinic patients 58{\%} pursued primary treatment at the university medical center. They were more likely to be younger, black and physician referred, have a lower income and reside closer to the medical center. Factors predictive of pursuing treatment at the medical center included high risk disease and physician referral. Factors predictive of not receiving care at the university medical center were income greater than $40,000 and a distance traveled of greater than 100 miles. Conclusions: A different patient demographic is using the multidisciplinary approach. However, when treatment is pursued at the institution providing multidisciplinary services, the patient demographic resembles that of the treating institution.",
author = "Suzanne Merrill and Baez, {Lionel L.} and Robertson, {Cary N.} and Freedland, {Stephen J.} and Polascik, {Thomas J.} and Donghua Xie and Koontz, {Bridget F.} and Zeljko Vujaskovic and Lee, {W. Robert} and Armstrong, {Andrew J.} and Febbo, {Phillip G.} and George, {Daniel J.} and Moul, {Judd W.}",
year = "2012",
month = "1",
day = "1",
doi = "10.1016/j.juro.2011.09.040",
language = "English (US)",
volume = "187",
pages = "103--108",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "1",

}

Merrill, S, Baez, LL, Robertson, CN, Freedland, SJ, Polascik, TJ, Xie, D, Koontz, BF, Vujaskovic, Z, Lee, WR, Armstrong, AJ, Febbo, PG, George, DJ & Moul, JW 2012, 'Utilization trends at a multidisciplinary prostate cancer clinic: Initial 5-year experience from the duke prostate center', Journal of Urology, vol. 187, no. 1, pp. 103-108. https://doi.org/10.1016/j.juro.2011.09.040

Utilization trends at a multidisciplinary prostate cancer clinic : Initial 5-year experience from the duke prostate center. / Merrill, Suzanne; Baez, Lionel L.; Robertson, Cary N.; Freedland, Stephen J.; Polascik, Thomas J.; Xie, Donghua; Koontz, Bridget F.; Vujaskovic, Zeljko; Lee, W. Robert; Armstrong, Andrew J.; Febbo, Phillip G.; George, Daniel J.; Moul, Judd W.

In: Journal of Urology, Vol. 187, No. 1, 01.01.2012, p. 103-108.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Utilization trends at a multidisciplinary prostate cancer clinic

T2 - Initial 5-year experience from the duke prostate center

AU - Merrill, Suzanne

AU - Baez, Lionel L.

AU - Robertson, Cary N.

AU - Freedland, Stephen J.

AU - Polascik, Thomas J.

AU - Xie, Donghua

AU - Koontz, Bridget F.

AU - Vujaskovic, Zeljko

AU - Lee, W. Robert

AU - Armstrong, Andrew J.

AU - Febbo, Phillip G.

AU - George, Daniel J.

AU - Moul, Judd W.

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Purpose: The multidisciplinary approach is becoming increasingly encouraged but little is known about the multidisciplinary experience compared to routine care. For patients with prostate cancer the goal is to provide evaluations by urologists, medical and radiation oncologists at a single visit. Although additional resources are required, this strategy may enhance the overall health care experience. We compared utilization determinants between a multidisciplinary and a urology prostate cancer clinic at Duke University Medical Center and identified factors associated with pursuing treatment at the university medical center for multidisciplinary clinic patients. Materials and Methods: We retrospectively analyzed data on patients referred for primary prostate cancer treatment evaluation at Duke University Medical Center from 2005 to 2009. Comparisons between 701 multidisciplinary clinic and 1,318 urology prostate cancer clinic patients were examined with the rank sum and chi-square tests. Predictive factors for pursuing treatment at the university medical center were assessed using multivariate adjusted logistic regression. Results: Compared to patients at the urology prostate cancer clinic those at the multidisciplinary clinic were more likely to be younger and white, have a higher income and travel a longer distance for evaluation. Of multidisciplinary clinic patients 58% pursued primary treatment at the university medical center. They were more likely to be younger, black and physician referred, have a lower income and reside closer to the medical center. Factors predictive of pursuing treatment at the medical center included high risk disease and physician referral. Factors predictive of not receiving care at the university medical center were income greater than $40,000 and a distance traveled of greater than 100 miles. Conclusions: A different patient demographic is using the multidisciplinary approach. However, when treatment is pursued at the institution providing multidisciplinary services, the patient demographic resembles that of the treating institution.

AB - Purpose: The multidisciplinary approach is becoming increasingly encouraged but little is known about the multidisciplinary experience compared to routine care. For patients with prostate cancer the goal is to provide evaluations by urologists, medical and radiation oncologists at a single visit. Although additional resources are required, this strategy may enhance the overall health care experience. We compared utilization determinants between a multidisciplinary and a urology prostate cancer clinic at Duke University Medical Center and identified factors associated with pursuing treatment at the university medical center for multidisciplinary clinic patients. Materials and Methods: We retrospectively analyzed data on patients referred for primary prostate cancer treatment evaluation at Duke University Medical Center from 2005 to 2009. Comparisons between 701 multidisciplinary clinic and 1,318 urology prostate cancer clinic patients were examined with the rank sum and chi-square tests. Predictive factors for pursuing treatment at the university medical center were assessed using multivariate adjusted logistic regression. Results: Compared to patients at the urology prostate cancer clinic those at the multidisciplinary clinic were more likely to be younger and white, have a higher income and travel a longer distance for evaluation. Of multidisciplinary clinic patients 58% pursued primary treatment at the university medical center. They were more likely to be younger, black and physician referred, have a lower income and reside closer to the medical center. Factors predictive of pursuing treatment at the medical center included high risk disease and physician referral. Factors predictive of not receiving care at the university medical center were income greater than $40,000 and a distance traveled of greater than 100 miles. Conclusions: A different patient demographic is using the multidisciplinary approach. However, when treatment is pursued at the institution providing multidisciplinary services, the patient demographic resembles that of the treating institution.

UR - http://www.scopus.com/inward/record.url?scp=83555162521&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=83555162521&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2011.09.040

DO - 10.1016/j.juro.2011.09.040

M3 - Article

VL - 187

SP - 103

EP - 108

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 1

ER -