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Table 2 Outcomes for prostate cancer care in patients by PCPs with a high or low PSA ordering rate

From: 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

Outcomes Test/Treatment/Service type N (%) Odds Ratio (95 % CI), High vs. Low
High (N = 22853) Low (N = 23929)
Diagnostic Test
 PSA test 18889 (82.7) 13808 (57.7) 3.64 (3.48, 3.80)
 Biopsy 546 (2.4) 497 (2.1) 1.16 (1.02, 1.31)
 Ultrasound 774 (3.4) 688 (2.9) 1.19 (1.07, 1.32)
 Imaging 196 (0.9) 174 (0.7) 1.18 (0.96, 1.45)
Treatment
 Any treatment for prostate cancer 270 (1.2) 258 (1.1) 1.10 (0.93, 1.31)
 Radiation 159 (0.7) 124 (0.5) 1.31 (1.03, 1.66)
 Radical prostatectomy 18 (0.1) 30 (0.1) 0.67 (0.37, 1.21)
 Androgen deprivation therapy 166 (0.7) 162 (0.7) 1.11 (0.89, 1.38)
Health Services
 Outpatient office visit for prostate cancer 413 (1.8) 365 (1.5) 1.21 (1.05, 1.39)
 Outpatient office visit to urologists 8087 (35.4) 8434 (35.2) 0.98 (0.94, 1.02)
 Without any prostate cancer associated utilization listed above 3915 (17.1) 10046 (42.0) 0.27 (0.26, 0.29)
  1. The average adjusted rate of ordering PSA test in 550 high test rate PCPs in 2009 was 63.0 ± 10.4. The average adjusted rate of ordering PSA test in 638 low test rate PCPs in 2009 was 7.6 ± 5.2. The odds ratio was estimated by logistic models adjusted for age, ethnicity, comorbidity, Medicaid eligibility, urban or rural residence and education at the zip code level. 80 (0.17 %) men with unknown urban/rural residence or education information were excluded. Prostate cancer associated utilization did not include outpatient office visits to urologists as the reason for the visit was not limited to prostate cancer
  2. CI confidence interval, PCP primary care provider, PSA prostate specific antigen