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Physician Social Networks and Variation in Prostate Cancer Treatment in Three Cities
Author(s) -
Pollack Craig Evan,
Weissman Gary,
Bekelman Justin,
Liao Kaijun,
Armstrong Katrina
Publication year - 2012
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2011.01331.x
Subject(s) - prostatectomy , medicine , prostate cancer , odds , socioeconomic status , receipt , demography , ethnic group , odds ratio , family medicine , oncology , cancer , logistic regression , population , environmental health , sociology , world wide web , computer science , anthropology
Objective To examine whether physician social networks are associated with variation in treatment for men with localized prostate cancer. Data Source 2004–2005 S urveillance, E pidemiology and E nd R esults‐ M edicare data from three cities. Study Design We identified the physicians who care for patients with prostate cancer and created physician networks for each city based on shared patients. Subgroups of urologists were defined as physicians with dense connections with one another via shared patients. Principal Findings Subgroups varied widely in their unadjusted rates of prostatectomy and the racial/ethnic and socioeconomic composition of their patients. There was an association between urologist subgroup and receipt of prostatectomy. In city A, four subgroups had significantly lower odds of prostatectomy compared with the subgroup with the highest rates of prostatectomy after adjusting for patient clinical and sociodemographic characteristics. Similarly, in cities B and C, subgroups had significantly lower odds of prostatectomy compared with the baseline. Conclusions Using claims data to identify physician networks may provide an insight into the observed variation in treatment patterns for men with prostate cancer.