67th Annual Meeting Abstracts
Does In-sourcing Pathology Services in a Large Private Practice Urology Group Increase the Utilization of Prostate Biopsy?
Eugene V Kramolowsky, Dharam Ramnani, Nada L Wood
Virginia Urology, Richmond, VA
Introduction: Addition of ancillary services to a urology practice can increase utilization of these services. Does addition of integrated pathology services (as partner) in a large single-specialty urology practice increased utilization of prostate biopsy and detection of prostate cancer (CaP)?
Materials & Methods: The practice's database was used to analyze 23,019 consecutive patients undergoing prostate biopsy over 13 years (1/95 to 1/08). All biopsies were done by urologist in the practice. During study period, the number of practicing urologists increased 42 % from 19 to 27. In 2004, biopsy protocol was changed from 6/8 cores to 12 cores. Comparison was made over time (yearly) of numbers of patients biopsied, positive biopsies, and urology full time equivalents (FTE) to determine if inclusion of pathology services impacted biopsy and CaP rate. Patient data (age and PSA) was compared to detect variation in the population.
Results: Over study period, number of patients biopsied per year increased 132% (1076 in 1995 to 2497 in 2007). Detection of prostate cancer increased from 31% in 1995 to 41% in 2007. Number of patients biopsied per urologist increased from 56.6/FTE to 92.5/FTE and CaP detection increased from 17.5/ FTE to 38.7/FTE.. Age and PSA at biopsy and at detection of CaP decreased over the study period.
Conclusions: During study period, volume of prostate biopsies performed per FTE has increased as has CaP detection. These variations in utilization are most likely related to other factors such as increased practice volume and changes in biopsy protocol and PSA sensitivity.
