High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.

<h4>Background</h4>Among various treatment options for benign prostatic hyperplasia (BPH), surgical therapy is the most invasive. As Switzerland has the highest transurethral prostatectomy rate among OECD countries, we assessed the regional variation in prostate surgery for BPH and explo...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Maria M Wertli, Brigitta Zumbrunn, Pascal Weber, Alan G Haynes, Radoslaw Panczak, Arnaud Chiolero, Nicolas Rodondi, Drahomir Aujesky
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8414f789def74abf92ec289af25779f8
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:8414f789def74abf92ec289af25779f8
record_format	dspace
spelling	oai:doaj.org-article:8414f789def74abf92ec289af25779f82021-12-02T20:06:40ZHigh regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.1932-620310.1371/journal.pone.0254143https://doaj.org/article/8414f789def74abf92ec289af25779f82021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254143https://doaj.org/toc/1932-6203<h4>Background</h4>Among various treatment options for benign prostatic hyperplasia (BPH), surgical therapy is the most invasive. As Switzerland has the highest transurethral prostatectomy rate among OECD countries, we assessed the regional variation in prostate surgery for BPH and explored potential determinants of variation.<h4>Methods</h4>We conducted a population-based analysis using discharge data for men aged ≥40 years with transurethral or simple prostatectomy from all Swiss hospitals during 2013-2018. After excluding patients with genitourinary/prostate cancer, we derived hospital service areas (HSAs) by analyzing patient flows. We calculated age-standardized mean procedure rates and variation indices (extremal quotient [EQ] and systematic component of variation [SCV]). We estimated the reduction in variance across HSAs of prostatectomy rates in multilevel regression models, with incremental adjustment for age, regional cultural and socioeconomic factors, disease burden, density of urologists, and the time since urologists' graduation.<h4>Results</h4>Overall, 44,253 prostatectomies (42,710 transurethral and 1543 simple) from 44 HSAs were analyzed. The mean age-standardized prostate surgery rate was 314 (range 166-500) per 100,000 men aged ≥40 years per year. The EQ was 3.01 and the SCV 5.53, indicating a high regional variation. In multivariate models, men aged 75-79 years had an 11.6-fold higher prostatectomy rate than those aged 50-54 years. French/Italian language areas had a 21% lower rate than Swiss German speaking areas. Socioeconomic factors, disease burden, and density of urologist/time since graduation were not associated with prostatectomy rates. After full adjustment, 80% of the variance in prostate surgery across HSAs remained unexplained.<h4>Conclusion</h4>We found a remarkably high regional variation in prostate surgery rates for BPH within Switzerland.Maria M WertliBrigitta ZumbrunnPascal WeberAlan G HaynesRadoslaw PanczakArnaud ChioleroNicolas RodondiDrahomir AujeskyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254143 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maria M Wertli Brigitta Zumbrunn Pascal Weber Alan G Haynes Radoslaw Panczak Arnaud Chiolero Nicolas Rodondi Drahomir Aujesky High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.
description	<h4>Background</h4>Among various treatment options for benign prostatic hyperplasia (BPH), surgical therapy is the most invasive. As Switzerland has the highest transurethral prostatectomy rate among OECD countries, we assessed the regional variation in prostate surgery for BPH and explored potential determinants of variation.<h4>Methods</h4>We conducted a population-based analysis using discharge data for men aged ≥40 years with transurethral or simple prostatectomy from all Swiss hospitals during 2013-2018. After excluding patients with genitourinary/prostate cancer, we derived hospital service areas (HSAs) by analyzing patient flows. We calculated age-standardized mean procedure rates and variation indices (extremal quotient [EQ] and systematic component of variation [SCV]). We estimated the reduction in variance across HSAs of prostatectomy rates in multilevel regression models, with incremental adjustment for age, regional cultural and socioeconomic factors, disease burden, density of urologists, and the time since urologists' graduation.<h4>Results</h4>Overall, 44,253 prostatectomies (42,710 transurethral and 1543 simple) from 44 HSAs were analyzed. The mean age-standardized prostate surgery rate was 314 (range 166-500) per 100,000 men aged ≥40 years per year. The EQ was 3.01 and the SCV 5.53, indicating a high regional variation. In multivariate models, men aged 75-79 years had an 11.6-fold higher prostatectomy rate than those aged 50-54 years. French/Italian language areas had a 21% lower rate than Swiss German speaking areas. Socioeconomic factors, disease burden, and density of urologist/time since graduation were not associated with prostatectomy rates. After full adjustment, 80% of the variance in prostate surgery across HSAs remained unexplained.<h4>Conclusion</h4>We found a remarkably high regional variation in prostate surgery rates for BPH within Switzerland.
format	article
author	Maria M Wertli Brigitta Zumbrunn Pascal Weber Alan G Haynes Radoslaw Panczak Arnaud Chiolero Nicolas Rodondi Drahomir Aujesky
author_facet	Maria M Wertli Brigitta Zumbrunn Pascal Weber Alan G Haynes Radoslaw Panczak Arnaud Chiolero Nicolas Rodondi Drahomir Aujesky
author_sort	Maria M Wertli
title	High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.
title_short	High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.
title_full	High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.
title_fullStr	High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.
title_full_unstemmed	High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.
title_sort	high regional variation in prostate surgery for benign prostatic hyperplasia in switzerland.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/8414f789def74abf92ec289af25779f8
work_keys_str_mv	AT mariamwertli highregionalvariationinprostatesurgeryforbenignprostatichyperplasiainswitzerland AT brigittazumbrunn highregionalvariationinprostatesurgeryforbenignprostatichyperplasiainswitzerland AT pascalweber highregionalvariationinprostatesurgeryforbenignprostatichyperplasiainswitzerland AT alanghaynes highregionalvariationinprostatesurgeryforbenignprostatichyperplasiainswitzerland AT radoslawpanczak highregionalvariationinprostatesurgeryforbenignprostatichyperplasiainswitzerland AT arnaudchiolero highregionalvariationinprostatesurgeryforbenignprostatichyperplasiainswitzerland AT nicolasrodondi highregionalvariationinprostatesurgeryforbenignprostatichyperplasiainswitzerland AT drahomiraujesky highregionalvariationinprostatesurgeryforbenignprostatichyperplasiainswitzerland
_version_	1718375370435067904

High regional variation in prostate surgery for benign prostatic hyperplasia in Switzerland.

Ejemplares similares