WEDNESDAY, Sept. 12, 2018 — Patients with prostate cancer receiving care in a Medicare-only setting are more likely to receive guideline-discordant imaging, according to a study published online Aug. 17 in JAMA Network Open.
Danil V. Makarov, M.D., from New York University School of Medicine in New York City, and colleagues examined the correlation between prostate cancer imaging rates and a Veterans Affairs (VA) versus fee-for-service health care setting using data for men who received a diagnosis of prostate cancer from Jan. 1, 2004, through March 31, 2008. Of the 98,867 men with prostate cancer, 57.3, 14.5, and 28.1 percent were in the Medicare-only, VA and Medicare, and VA-only groups, respectively.
The researchers found that among men with low-risk prostate cancer, the highest rate of guideline-discordant imaging was seen in the Medicare-only group, followed by the VA and Medicare and the VA-only groups (52.5, 50.9, and 45.9 percent, respectively). For men with high-risk cancer, the imaging rates were not significantly different between the groups. Compared with individuals in the Medicare-only group, those in the VA and Medicare group and the VA-only group were significantly less likely to receive guideline-discordant imaging (risk ratios, 0.87 and 0.79, respectively) in multivariable analysis.
“The results of this study suggest that patients with prostate cancer who use Medicare rather than the VA for health care could experience more utilization of health care services without an improvement in the quality of care,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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Posted: September 2018