Appropriate and inappropriate imaging rates for prostate cancer go hand in hand by region, as if set by thermostat

Danil V. Makarov, Rani Desai, James B. Yu, Richa Sharma, Nitya E. Abraham, Peter C. Albertsen, Harlan M. Krumholz, David F. Penson, Cary P. Gross

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Policy makers interested in containing health care costs are targeting regional variation in utilization, including the use of advanced imaging. However, bluntly decreasing utilization among the highestutilization regions may have negative consequences. In a cross-sectional study of prostate cancer patients from 2004 to 2005, we found that regions with lower rates of inappropriate imaging also had lower rates of appropriate imaging. Similarly, regions with higher overall imaging rates tended to have not only higher rates of inappropriate imaging, but also higher rates of appropriate imaging. In fact, men with high-risk prostate cancer were more likely to receive appropriate imaging if they resided in areas with higher rates of inappropriate imaging. This "thermostat model" of regional health care utilization suggests that poorly designed policies aimed at reducing inappropriate imaging could limit access to appropriate imaging for high-risk patients. Health care organizations need clearly defined quality metrics and supportive systems to encourage appropriate treatment for patients and to ensure that cost containment does not occur at the expense of quality.

Original languageEnglish (US)
Pages (from-to)730-740
Number of pages11
JournalHealth Affairs
Volume31
Issue number4
DOIs
StatePublished - Apr 2012
Externally publishedYes

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Prostatic Neoplasms
Metric System
Patient Acceptance of Health Care
Cost Control
Administrative Personnel
Health Care Costs
Cross-Sectional Studies
Organizations
Delivery of Health Care
Therapeutics

ASJC Scopus subject areas

  • Health Policy

Cite this

Appropriate and inappropriate imaging rates for prostate cancer go hand in hand by region, as if set by thermostat. / Makarov, Danil V.; Desai, Rani; Yu, James B.; Sharma, Richa; Abraham, Nitya E.; Albertsen, Peter C.; Krumholz, Harlan M.; Penson, David F.; Gross, Cary P.

In: Health Affairs, Vol. 31, No. 4, 04.2012, p. 730-740.

Research output: Contribution to journalArticle

Makarov, DV, Desai, R, Yu, JB, Sharma, R, Abraham, NE, Albertsen, PC, Krumholz, HM, Penson, DF & Gross, CP 2012, 'Appropriate and inappropriate imaging rates for prostate cancer go hand in hand by region, as if set by thermostat', Health Affairs, vol. 31, no. 4, pp. 730-740. https://doi.org/10.1377/hlthaff.2011.0336
Makarov, Danil V. ; Desai, Rani ; Yu, James B. ; Sharma, Richa ; Abraham, Nitya E. ; Albertsen, Peter C. ; Krumholz, Harlan M. ; Penson, David F. ; Gross, Cary P. / Appropriate and inappropriate imaging rates for prostate cancer go hand in hand by region, as if set by thermostat. In: Health Affairs. 2012 ; Vol. 31, No. 4. pp. 730-740.
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