Effectiveness of interventions for reducing the frequency of radical prostatectomy procedures in the elderly: an evaluation.
Between 1993 and 1997, the Peer Review Organizations (PROs) implemented interventions for reducing radical prostatectomy rates in 50 selected hospitals in 10 states and all hospitals in an additional 4 states. Control hospitals and states were matched with the intervention hospitals and states. Prostate cancer incidence rates were used to estimate the number of Medicare beneficiaries aged 75 years and older with prostate cancer, the denominators for the procedure rates, in the hospital service area of each intervention and control hospital, and in each state and their controls. After interventions, significant reductions in the state-specific radical prostatectomy rates were achieved in the intervention hospitals in 2 states and in 1 of the 4 intervention states where statewide interventions had been implemented. Similar reductions were seen in the control hospitals in 3 other individual states and 8 states combined where hospital-based interventions were implemented. These changes in the procedure rates were most likely due to the national decline in the incidence of prostate cancer, not the PRO interventions.
Sheikh
Kazim
K
Centers for Medicare & Medicaid Services, US Department of Health and Human Services, Kansas City, MO 64106, USA. ksheikh@cms.hhs.gov
Bullock
Claudia
C
D000368:Aged; D006302:Health Services Research; D006801:Humans; D008297:Male; D011366:Professional Review Organizations; D015397:Program Evaluation; D011468:Prostatectomy / Q000379:methods / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000601:surgery*; D011785:Quality Assurance, Health Care; D013503:Surgery Department, Hospital / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D014481:United States; D014600:Utilization Review / Q000458:organization & administration*