scholarly journals The cost of treatment and its related complications for men who receive surgery or radiation therapy for prostate cancer

2018 ◽  
Vol 13 (8) ◽  
Author(s):  
Alaina Garbens ◽  
Christopher J.D. Wallis ◽  
Rano Matta ◽  
Ronald Kodama ◽  
Sender Herschorn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Negative Binomial ◽  
Relative Rate ◽  
Multivariable Analysis ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Open Radical Prostatectomy ◽  
Medication Costs ◽  
Total Treatment

Introduction: We sought to examine the costs related to treatment and treatment-related complications for patients treated with surgery or radiation for localized prostate cancer.Methods: We performed a population-based, retrospective cohort study of men who underwent open radical prostatectomy or radiation from 2004‒2009 in Ontario, Canada. Costs, including initial treatment and inpatient hospitalization, emergency room visit, outpatient consultation, physician billings, and medication costs, were determined for five years following treatment using a validated costing algorithm. Multivariable negative binomial regression was used to assess the association between treatment modality and costs.Results: A total of 28 849 men underwent treatment for localized prostate cancer from 2004–2009. In the five years following treatment, men who underwent radiation (n=12 675) had 21% higher total treatment and treatment-related costs than men who underwent surgery ($16 716/person vs. $13 213/person). Based on multivariable analysis, while men who underwent XRT had a lower relative cost in their first year after treatment (relative rate [RR] 0.97; 95% confidence interval [CI] 0.94–1.0; p=0.025), after year 2, annual costs were significantly higher in the radiation group compared to the surgery group (total cost for year 5, RR 1.44; 95% CI 1.17–1.76; p<0.0001). Our results were similar when restricted to young, healthy men and to older men.Conclusions: Men who undergo radiation have significantly higher five-year total treatment-related costs compared to men who undergo open radical prostatectomy. While surgery was associated with slightly higher initial costs, radiotherapy had higher costs in subsequent years.

scholarly journals The impact of teaching on the duration of common urological operations

2016 ◽  
Vol 10 (5-6) ◽  
pp. 172 ◽  
Author(s):  
Blayne Welk ◽  
Jennifer Winick-Ng ◽  
Andrew McClure ◽  
Chris Vinden ◽  
Sumit Dave ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Potential Effect ◽  
Sensitivity Analyses ◽  
Teaching Hospitals ◽  
Operative Duration ◽  
Open Radical Prostatectomy ◽  
Academic Hospitals ◽  
The Impact

Introduction: The ability of academic (teaching) hospitals to offer the same level of efficiency as non-teaching hospitals in a publicly funded healthcare system is unknown. Our objective was to compare the operative duration of general urology procedures between teaching and non-teaching hospitals. Methods: We used administrative data from the province of Ontario to conduct a retrospective cohort study of all adults who underwent a specified elective urology procedure (2002–2013). Primary outcome was duration of surgical procedure. Primary exposure was hospital type (academic or non-teaching). Negative binomial regression was used to adjust relative time estimates for age, comorbidity, obesity, anesthetic, and surgeon and hospital case volume.Results: 114 225 procedures were included (circumcision n=12 280; hydrocelectomy n=7221; open radical prostatectomy n=22 951; transurethral prostatectomy n=56 066; or mid-urethral sling n=15 707). These procedures were performed in an academic hospital in 14.8%, 13.3%, 28.6%, 17.1%, and 21.3% of cases, respectively. The mean operative duration across all procedures was higher in academic centres; the additional operative time ranged from 8.3 minutes (circumcision) to 29.2 minutes (radical prostatectomy). In adjusted analysis, patients treated in academic hospitals were still found to have procedures that were significantly longer (by 10‒21%). These results were similar in sensitivity analyses that accounted for the potential effect of more complex patients being referred to tertiary academic centres.Conclusions: Five common general urology operations take significantly longer to perform in academic hospitals. The reason for this may be due to the combined effect of teaching students and residents or due to inherent systematic inefficiencies within large academic hospitals.

scholarly journals Author self-citation in orthodontics is associated with author origin and gender

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Christos Livas ◽  
Konstantina Delli ◽  
Nikolaos Pandis
Keyword(s):  
Negative Binomial ◽  
Case Reports ◽  
Citation Rate ◽  
Multivariable Analysis ◽  
Negative Binomial Regression ◽  
Original Research ◽  
Journal Citation Reports ◽  
Citation Counts ◽  
And Gender ◽  
Study Type

Abstract Background The aims of this bibliometric study were to determine author self-citation trends in high-impact orthodontic literature and to investigate possible association between self-citation and publication characteristics. Methods Six orthodontic journals with the highest impact factor as ranked by 2017 Journal Citation Reports were screened for a full publication year (2018) for original research articles, reviews, and case reports. Eligible articles were scrutinized for article and author characteristics and citation metrics. Univariable and multivariable negative binomial regression was used to examine associations between self-citation incidence and publication characteristics. Results Medians for author self-citation rate of the most self-citing authors and self-citations were 3.03% (range 0–50) and 1 (range 0–19), respectively. In the univariable analysis, there was no association between self-citation counts and study type (P = 0.41), article topic (P = 0.61), number of authors (P = 0.62), and rank of authors (P = 0.56). Author origin (P = 0.001), gender (P = 0.001) and journal (P = 0.05) were associated with self-citation counts and in the multivariable analysis only origin and gender remained strong self-citation predictors. Asian authors and females self-cited significantly less often than all other regions and male authors. Conclusions Authors in orthodontics do not self-cite at a frequency that suggests potential citation manipulation. Author origin and gender were the only variables associated with citations counts. More bibliometric research is necessary to draw solid conclusions about author self-citation trends in orthodontic literature.

scholarly journals Sex differences in health services and medication use among older adults with asthma

2019 ◽  
Vol 5 (4) ◽  
pp. 00242-2019
Author(s):  
Teresa To ◽  
Natasha Gray ◽  
Kandace Ryckman ◽  
Jingqin Zhu ◽  
Ivy Fong ◽  
...  
Keyword(s):  
Sex Differences ◽  
Health Services ◽  
Older Women ◽  
Negative Binomial ◽  
Relative Rate ◽  
Medication Use ◽  
Negative Binomial Regression ◽  
Office Visits ◽  
Health Services Use ◽  
Physician Office

Sex differences are well documented in chronic disease populations with cardiovascular disease and diabetes. Although recent research has suggested that asthma is more severe in older women compared to men, the extent of this difference remains poorly understood. The objective of this study was to compare rates of asthma-specific health services use (HSU) and medication use, between older women and men with asthma.This population-based cohort study included 209 054 individuals aged ≥66 years with asthma from health administrative data in Ontario, Canada. The primary exposure was sex. Outcomes included asthma-specific HSU (spirometry, emergency department (ED), hospitalisation, physician office and specialist visits) and medication use (asthma controller and reliever prescriptions). Negative binomial regression models adjusted for age, socioeconomic status and comorbidities were used to ascertain outcomes by sex from 2010 to 2016.Compared to men, women had lower rates of spirometry (adjusted relative rate (ARR) 0.87, 95% CI 0.85–0.89) and specialist visits for asthma (ARR 0.93, 95% CI 0.90–0.96), but higher rates of asthma-specific ED (ARR 1.43, 95% CI 1.33–1.53) and physician office visits (ARR 1.03, 95% CI 1.01–1.05). Women also had lower asthma controller (ARR 0.98, 95% CI 0.97–0.99) but higher asthma reliever (ARR 1.03, 95% CI 1.02–1.05) prescription fill rates, compared to men.These findings may indicate poorer disease control, greater asthma severity and poorer access to specialist asthma care in women.

Survival after radical prostatectomy for clinically localised prostate cancer: a population-based study

2013 ◽  
Vol 113 (4) ◽  
pp. 541-547 ◽  
Author(s):  
Martin Andreas Røder ◽  
Klaus Brasso ◽  
Ib Jarle Christensen ◽  
Jørgen Johansen ◽  
Niels Christian Langkilde ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Population Based ◽  
Population Based Study

scholarly journals Evaluation of community coalition training effects on youth hospital-admitted injury incidence in Victoria, Australia: 2001–2017

2019 ◽  
Vol 26 (5) ◽  
pp. 463-470 ◽  
Author(s):  
Janneke Berecki-Gisolf ◽  
Bosco Rowland ◽  
Nicola Reavley ◽  
Barbara Minuzzo ◽  
John Toumbourou
Keyword(s):  
Risk Factors ◽  
Injury Risk ◽  
Negative Binomial ◽  
Hospital Admissions ◽  
Intervention Strategy ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Injury Incidence ◽  
The Impact

BackgroundInjuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors.MethodUsing a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups.ResultsStatistically significant relative reductions in all hospital injury admissions in 0–4 year olds were associated with communities completing the CTC process and in 0–19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries.ConclusionThe findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.

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