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Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S.

Overview of attention for article published in BMC Health Services Research, January 2016
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Title
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort study
Published in
BMC Health Services Research, January 2016
DOI 10.1186/s12913-016-1265-1
Pubmed ID
Authors

Preeti Zanwar, Yu-Li Lin, Yong-Fang Kuo, James S. Goodwin

Abstract

All authorities recommend against prostate specific antigen (PSA) screening in men 75 years and older. However, some primary care physicians (PCPs) continue to have high rates of PSA, with large variation in testing. We assessed the tests, treatments, and payments for prostate cancer care in men aged 75 or older who have PCPs with high or low PSA testing rates. We performed a retrospective cohort study using the 2010 Medicare beneficiaries aged 75 or older in Texas, United States who had no prostate cancer in 2007-2009 and had an identifiable PCP. We first identified high vs. low PSA testing PCPs, and then grouped older men in the two PCP groups. We determined health care visits to any provider and to urologists in office and outpatient settings. We estimated the direct medical payments for prostate cancer care for diagnostics, treatments and visits to providers in 2010-2011 using the generalized gamma model with log link function. In multilevel, multivariable analyses, 25.4 % (n = 550) of PCPs had PSA testing rates in men aged 75 or older that were significantly higher than the mean rate of all 2,169 Texas PCPs; 29.4 % (n = 638) had rates that were significantly lower. In all, 22,853 vs. 23,929 older men were cared for by PCPs with high vs. low testing rates. Older men cared for by high PSA rate PCPs were more likely to receive a PSA test (OR 3.64, 95 % CI 3.48-3.80), a biopsy (OR 1.16, 95 % CI 1.02-1.31), an ultrasound (OR 1.19, 95 % CI 1.07-1.32) or any radiation treatment (OR 1.31, 95 % CI 1.03-1.66) than men cared for by low PSA rate PCPs. Men with high PSA rate PCPs were 1.21 (95 % CI 1.05-1.39) times more likely to have such outpatient visits. The average annual adjusted Medicare payments for prostate cancer care was $25.60 higher for patients cared for by PCPs with high PSA test rates. Older men seeing PCPs with high rates of PSA testing undergo more testing and treatments for prostate cancer, with higher Medicare insurance payments. Future studies are needed to delineate whether men seeing PCPs with low testing rates likely received PSA tests from other providers.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 17 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Netherlands 1 6%
Unknown 16 94%

Demographic breakdown

Readers by professional status Count As %
Researcher 6 35%
Student > Master 4 24%
Student > Bachelor 1 6%
Student > Doctoral Student 1 6%
Other 1 6%
Other 0 0%
Unknown 4 24%
Readers by discipline Count As %
Medicine and Dentistry 8 47%
Economics, Econometrics and Finance 1 6%
Computer Science 1 6%
Psychology 1 6%
Social Sciences 1 6%
Other 1 6%
Unknown 4 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 May 2018.
All research outputs
#10,959,156
of 13,796,475 outputs
Outputs from BMC Health Services Research
#3,909
of 4,652 outputs
Outputs of similar age
#200,954
of 273,110 outputs
Outputs of similar age from BMC Health Services Research
#3
of 4 outputs
Altmetric has tracked 13,796,475 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 4,652 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one is in the 7th percentile – i.e., 7% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 273,110 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 14th percentile – i.e., 14% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 4 others from the same source and published within six weeks on either side of this one.