Hospitalizations in Patients With Prostate Cancer on Medicare
In a retrospective analysis reported in the Journal of Oncology Practice, Parikh et al found that more than one-quarter of hospitalizations in Medicare patients with prostate cancer were potentially avoidable.
Study Details
The study involved 99 evaluable patients in the Mount Sinai Health System hospitalized between January 2012 and June 2015. In an initial stage of admission review, two clinicians independently evaluated admissions records using case review forms to assess for potentially avoidable hospitalizations. If the clinicians did not agree on or were unsure of avoidable status, cases were reexamined by a larger group of clinicians to achieve consensus determination regarding avoidability.
Rate of Potentially Avoidable Admissions
On the consensus-driven clinical review, it was determined that 28.3% of hospital admissions were potentially avoidable. On univariate analysis, factors associated with increased likelihood of avoidable admission were admission for symptoms related to cancer or pain (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 likelihood of avoidable admission (OR = 0.32, P = .011). Factors that remained significant on multivariate analysis were 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).
The investigators concluded, “A significant proportion of hospitalizations among patients with prostate cancer are potentially avoidable. Understanding factors predictive of risk for [potentially avoidable hospitalizations] can help inform programs aimed at avoiding such admissions to improve overall care quality and value.”
Anish B. Parikh, MD, of Tisch Cancer Institute, Division of Hematology/Medical Oncology, Icahn School of Medicine at Mount Sinai, is the corresponding author for the Journal of Oncology Practice article.
Disclosure: The study authors' full disclosures can be found at jop.ascopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
