The immediate effects of private equity acquisition of urology practices on the management of newly diagnosed prostate cancer.
The immediate effects of private equity acquisition of urology practices on the management of newly diagnosed prostate cancer.
复制标题
作者：
一些人担心，私募股权收购的医生业务可能会增加服务的使用，以实现收入最大化。我们评估了私募股权收购对前列腺癌患者支出、治疗使用和诊断测试的影响。我们使用了20%的国家医疗保险索赔样本，对2014年至2019年诊断出前列腺癌的男性进行了回顾性队列研究。主要结果是诊断后的前12个月的前列腺癌花费。次要结局包括在诊断后的头12个月内使用治疗和诊断测试的综合措施（如影像学、基因组学）。采用多水平模型来调整患者和市场特征的差异。实践习得对每个结果的影响采用差中差设计进行评估。分别有409名和4021名前列腺癌患者接受泌尿科医生的后天性和非后天性治疗。获得性治疗后，获得性治疗和非获得性治疗之间的前列腺癌支出具有可比性（差中差估计为1182美元，p = 0.36）。在接受治疗的男性（差异-差异5.5%,p = 0.12）和保守治疗的男性（差异-差异2.0%,p = 0.82）中，获得性不影响治疗的使用（差异-差异估计3.7%,p = 0.30）或诊断测试的使用。在收购泌尿科业务后的一年里，私募股权并没有增加前列腺癌支出，也没有增加前列腺癌患者治疗或诊断测试的使用。今后的工作应在较长的时间范围内评估私募股权收购对业务模式和质量的影响。
Some worry that physician practices acquired by private equity may increase the use of services to maximize revenue. We assessed the effects of private equity acquisition on spending, use of treatment, and diagnostic testing in men with prostate cancer. We used a 20% sample of national Medicare claims to perform a retrospective cohort study of men with prostate cancer diagnosed from 2014 through 2019. The primary outcome was prostate cancer spending in the first 12 months after diagnosis. Secondary outcomes included the use of treatment and a composite measure of diagnostic testing (e.g., imaging, genomics) in the first 12 months after diagnosis. Multilevel modeling was used to adjust for differences in patient and market characteristics. The effect of practice acquisition on each outcome was assessed using a difference‐in‐differences design. There were 409 and 4021 men with prostate cancer managed by urologists in acquired and nonacquired practices, respectively. After acquisition, prostate cancer spending was comparable between acquired and nonacquired practices (difference‐in‐differences estimate $1182, p = 0.36). Acquisition did not affect the use of treatment (difference‐in‐differences estimate 3.7%, p = 0.30) or the use of diagnostic testing in men who were treated (difference‐in‐differences −5.5%, p = 0.12) and those managed conservatively (difference‐in‐differences −2.0%, p = 0.82). In the year following acquisition of urology practices, private equity did not increase prostate cancer spending, the use of treatment or diagnostic testing in men with prostate cancer. Future work should evaluate the effects of private equity acquisition on practice patterns and quality over a longer time horizon.
登录
查看更多内容
影响因子：
7.2
作者：
Klabunde, CN;Potosky, AL;Warren, JL
通讯作者：
Warren, JL
影响因子：
9.7
作者：
O'Donnell, Eloise May;Lelli, Gary Joseph;Casalino, Lawrence P.
通讯作者：
Casalino, Lawrence P.
影响因子：
0.8
作者：
Modi PK;Yan P;Hollenbeck BK;Kaufman SR;Borza T;Skolarus TA;Schroeck FR;Ryan AM;Shahinian VB;Herrel LA
通讯作者：
Herrel LA
影响因子：
10.9
作者：
Anderson, Alyce M.;Matsumoto, Martha;Ferris, Laura K.
通讯作者：
Ferris, Laura K.
影响因子：
158.5
作者：
Roux, AVD;Merkin, SS;Watson, RL
通讯作者：
Watson, RL