PMID- 30742550
OWN - NLM
STAT- MEDLINE
DCOM- 20200619
LR  - 20200619
IS  - 1935-469X (Electronic)
IS  - 1554-7477 (Linking)
VI  - 15
IP  - 3
DP  - 2019 Mar
TI  - Identifying Potentially Avoidable Hospitalizations in Medicare Patients With 
      Prostate Cancer: A Retrospective Analysis.
PG  - e187-e194
LID - 10.1200/JOP.18.00560 [doi]
AB  - PURPOSE: If identifiable, potentially avoidable hospitalizations (PAHs) can serve 
      as an important target for cost containment efforts in oncology. METHODS: PAHs 
      among a cohort of Medicare patients with prostate cancer were identified using a 
      two-stage consensus-driven review process. In stage 1, two clinicians 
      independently evaluated admissions records using a case review form, which we 
      modified from a previous study to assess for PAHs. In stage 2, any admissions 
      that the reviewers disagreed on or were unsure of were re-examined in a larger 
      group of clinicians to yield a consensus determination regarding avoidability. 
      Univariable and multivariable regression analyses were performed to identify 
      factors predictive of PAH. RESULTS: There were 160 admissions among this cohort 
      of 210 patients from January 2012 to June 2015, of which 99 were evaluable. 
      Consensus-driven clinical review yielded an overall PAH rate of 28.3%. Factors 
      associated with increased PAH risk were admission for symptoms related to cancer 
      (odds ratio [OR], 7.33; P < .001), presence of a social contributor to admission 
      (OR, 4.40; P = .014), and history of alcohol or drug abuse (OR, 4.93; P = .025). 
      Admission for a noncancer condition was associated with decreased PAH risk (OR, 
      0.32; P = .011). On multivariable analysis, presence of a social contributor to 
      admission (OR, 9.35; P = .002) and admission as a result of a noncancer condition 
      (OR, 0.16; P = .038) remained predictive of PAH risk. CONCLUSION: A significant 
      proportion of hospitalizations among patients with prostate cancer are 
      potentially avoidable. Understanding factors predictive of risk for PAH can help 
      inform programs aimed at avoiding such admissions to improve overall care quality 
      and value.
FAU - Parikh, Anish B
AU  - Parikh AB
AD  - 1 Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
FAU - Smith, William
AU  - Smith W
AD  - 2 Icahn School of Medicine at Mount Sinai, New York, NY.
FAU - Sanderson, Mark
AU  - Sanderson M
AD  - 2 Icahn School of Medicine at Mount Sinai, New York, NY.
FAU - Dharmarajan, Kavita
AU  - Dharmarajan K
AD  - 2 Icahn School of Medicine at Mount Sinai, New York, NY.
FAU - Liu, Mark
AU  - Liu M
AD  - 1 Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
FAU - Isola, Luis
AU  - Isola L
AD  - 1 Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
FAU - Ennis, Ronald D
AU  - Ennis RD
AD  - 3 Rutgers-Cancer Institute of New Jersey, New Brunswick, NJ.
LA  - eng
PT  - Journal Article
DEP - 20190211
PL  - United States
TA  - J Oncol Pract
JT  - Journal of oncology practice
JID - 101261852
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Health Care Costs
MH  - *Hospitalization
MH  - Humans
MH  - Male
MH  - *Medicare
MH  - Middle Aged
MH  - Odds Ratio
MH  - Prostatic Neoplasms/diagnosis/*epidemiology/therapy
MH  - Public Health Surveillance
MH  - Quality of Health Care
MH  - Retrospective Studies
MH  - United States/epidemiology
EDAT- 2019/02/12 06:00
MHDA- 2020/06/20 06:00
CRDT- 2019/02/12 06:00
PHST- 2019/02/12 06:00 [pubmed]
PHST- 2020/06/20 06:00 [medline]
PHST- 2019/02/12 06:00 [entrez]
AID - 10.1200/JOP.18.00560 [doi]
PST - ppublish
SO  - J Oncol Pract. 2019 Mar;15(3):e187-e194. doi: 10.1200/JOP.18.00560. Epub 2019 Feb 
      11.