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Geographic variations in the use of medical and surgical therapies for benign prostatic hyperplasia.

Publication ,  Journal Article
Sung, JC; Curtis, LH; Schulman, KA; Albala, DM
Published in: J Urol
March 2006

PURPOSE: Patients with BPH have several treatment options. Little is known about geographic variations in surgical rates for BPH and the market relationships to medical therapy, health resources and sociodemographic factors. MATERIALS AND METHODS: We conducted a cross-sectional study using administrative data from 5 states in 2000. Rates of surgical and medical therapy were calculated per 100,000 men 55 years old or older. Main outcome measures were county level weighted coefficient of variation and systematic component of variation in therapy rates, as well as surgery rates as a function of medication dispensing rates, health care resources and sociodemographic characteristics. RESULTS: North Carolina had the lowest surgery rates (26.3 minimally invasive procedures and 332.1 invasive surgeries per 100,000) and finasteride dispensing rates (503.5 per 100,000). Overall rates of medical therapy were 5 times higher than surgery rates. Geographic variations in surgical and medical therapy rates were significant for each state, and North Carolina had the greatest variation. An increase of 11.6 per 100,000 (95% CI, 6.5-55.8) in annual county level finasteride dispensing would be associated with a decrease in the surgery rate of 1 per 100,000, controlling for other variables. CONCLUSIONS: There is significant systematic variation in rates of surgical and medical therapy for BPH at county and state levels. The relationship between finasteride and surgery in randomized clinical trials is generalizable to the marketplace. Finasteride rates are inversely related to surgery rates, and tamsulosin rates are positively associated with surgery rates. Surgery rates are not significantly associated with urologists per capita.

Duke Scholars

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

March 2006

Volume

175

Issue

3 Pt 1

Start / End Page

1023 / 1027

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urologic Surgical Procedures
  • United States
  • Prostatic Hyperplasia
  • Middle Aged
  • Male
  • Humans
  • Finasteride
  • Enzyme Inhibitors
  • Drug Utilization
 

Citation

APA
Chicago
ICMJE
MLA
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Sung, J. C., Curtis, L. H., Schulman, K. A., & Albala, D. M. (2006). Geographic variations in the use of medical and surgical therapies for benign prostatic hyperplasia. J Urol, 175(3 Pt 1), 1023–1027. https://doi.org/10.1016/S0022-5347(05)00409-X
Sung, Jeffrey C., Lesley H. Curtis, Kevin A. Schulman, and David M. Albala. “Geographic variations in the use of medical and surgical therapies for benign prostatic hyperplasia.J Urol 175, no. 3 Pt 1 (March 2006): 1023–27. https://doi.org/10.1016/S0022-5347(05)00409-X.
Sung JC, Curtis LH, Schulman KA, Albala DM. Geographic variations in the use of medical and surgical therapies for benign prostatic hyperplasia. J Urol. 2006 Mar;175(3 Pt 1):1023–7.
Sung, Jeffrey C., et al. “Geographic variations in the use of medical and surgical therapies for benign prostatic hyperplasia.J Urol, vol. 175, no. 3 Pt 1, Mar. 2006, pp. 1023–27. Pubmed, doi:10.1016/S0022-5347(05)00409-X.
Sung JC, Curtis LH, Schulman KA, Albala DM. Geographic variations in the use of medical and surgical therapies for benign prostatic hyperplasia. J Urol. 2006 Mar;175(3 Pt 1):1023–1027.
Journal cover image

Published In

J Urol

DOI

ISSN

0022-5347

Publication Date

March 2006

Volume

175

Issue

3 Pt 1

Start / End Page

1023 / 1027

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urologic Surgical Procedures
  • United States
  • Prostatic Hyperplasia
  • Middle Aged
  • Male
  • Humans
  • Finasteride
  • Enzyme Inhibitors
  • Drug Utilization