Increased Use of IMRT for Self-Referring Urologists

(HealthDay News) – Use of integrated intensity-modulated radiation therapy (IMRT) has increased more among urologists who have acquired ownership of IMRT services vs. urologists who do not own such services, according to research published in the Oct. 24 issue of the New England Journal of Medicine.

Jean M. Mitchell, PhD, from Georgetown University in Washington, DC, discusses the correlation between ownership of IMRT services and use of IMRT to treat prostate cancer. Using Medicare claims from 2005–2010, data were collected for two samples: one comprising 35 self-referring and 35 matched non-self-referring urology groups, each in private practice, and the second comprising 11 self-referring urology groups in private practice with non-self-referring urologists employed at 11 National Comprehensive Cancer Network centers. The use of IMRT was compared in the periods before and during ownership.

Mitchell found that there was a significant increase in the rate of IMRT use by self-referring urologists in private practice, from 13.1% to 32.3% (P<0.001). The rate of IMRT use increased from 14.3% to 15.6% (P=0.05) among non-self-referring urologists (unadjusted difference-in-differences effect, 17.9 percentage points). There was a significant regression-adjusted increase in IMRT use of 16.4 percentage points associated with self-referral. The rate of IMRT use remained stable at 8% among urologists working at National Comprehensive Cancer Network centers, but an increase of 33 percentage points was noted among the matched self-referring groups.

“Urologists who acquired ownership of IMRT services increased their use of IMRT substantially more than urologists who did not own such services,” Mitchell writes. “Allowing urologists to self-refer for IMRT may contribute to increased use of this expensive therapy.”

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