title: Comparative analysis of benign prostatic hyperplasia management by urologists and nonurologists: a Korean nationwide health insurance database study.
abstract: OBJECTIVE
  To compare the current management of benign prostatic hyperplasia (BPH) by urologists and nonurologists by use of Korean nationwide health insurance data.
  
  
  METHODS
  We obtained patient data from the national health insurance system. New patients diagnosed with BPH in 2009 were divided into two groups depending on whether they were diagnosed by a urologist (U group) or by a nonurologist (NU group).
  
  
  RESULTS
  A total of 390,767 individuals were newly diagnosed with BPH in 2009. Of these, 240,907 patients (61.7%) were in the U group and 149,860 patients (38.3%) were in the NU group. The rate of all initial evaluation tests, except serum creatinine, was significantly lower in the NU group. The initial prescription rate was higher in the U group, whereas the prescription period was longer in the NU group. Regarding the initial drugs prescribed, the use of alpha-blockers was common in both groups. However, the U group was prescribed combination therapy of an alpha-blocker and 5-alpha-reductase inhibitor as the second choice, whereas the NU group received monotherapy with a 5-alpha-reductase inhibitor. During the 1-year follow-up, the incidence of surgery was significantly different between the U group and the NU group.
  
  
  CONCLUSIONS
  There are distinct differences in the diagnosis and treatment of BPH by urologists and nonurologists in Korea. These differences may have adverse consequences for BPH patients. Urological societies should take a leadership role in the management of BPH and play an educational role for nonurologists as well as urologists.
authors.affiliation: Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Juhyun
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Urology, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Urology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
authors.forename: Tag Keun
authors.initials: TK
authors.lastname: Yoo
authors.affiliation: Department of Urology, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Chung
authors.affiliation: Department of Urology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Seok-Joong
authors.initials: SJ
authors.lastname: Yun
authors.affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jun Hyuk
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seong Il
authors.initials: SI
authors.lastname: Seo
authors.affiliation: Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Urology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hwancheol
authors.initials: H
authors.lastname: Son
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D019468:Disease Management; D006801:Humans; D007348:Insurance, Health; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011470:Prostatic Hyperplasia / Q000175:diagnosis* / Q000628:therapy*; D056910:Republic of Korea; D014572:Urology / Q000379:methods*; D055815:Young Adult
chemical_list: D058891:5-alpha Reductase Inhibitors; D000317:Adrenergic alpha-Antagonists
keywords: Epidemiology; Insurance claim review; Prostatic hyperplasia