Original articleRadical Prostatectomy Trends in the United States: 1998 to 2011
Section snippets
Study Data
After receiving approval from the Mayo Clinic Institutional Review Board, we extracted data for the period from 1998 to 2011 from the Nationwide Inpatient Sample (NIS) files of the Healthcare Cost and Utilization Project within the US Agency for Healthcare Research and Quality. The NIS contains discharge data both at the patient level and at the hospital level from states that participate in the Healthcare Cost and Utilization Project. Comprising data from approximately 1000 US hospitals
Results
Weighted estimates revealed that 962,917 men older than 45 years underwent RP at all nonfederally funded hospitals in the United States during the study period. The quarterly rate of total RPs in the United States remained stable during the study period, from 341 RPs per million adult men older than 45 years in the first quarter of 1998 to 337 RPs per million adult men older than 45 years in the last quarter of 2011 (incidence rate ratio [IRR], 1.00; 95% CI, 1.00-1.00; P=.90) (Figure 1). There
Discussion
Our study demonstrates several new and interesting findings about the volume and distribution of RP in the United States, with numerous potential clinical implications. First, the annual rate of RP remained relatively stable between 1998 and 2011. There was a somewhat expected, yet substantial, decline in the rate of open RP, but this decline was roughly paralleled by the rapid expansion of MI-RP, which was especially apparent after the fourth quarter of 2008 when the ICD-9 code for RP was
Conclusion
The per capita utilization rate of RP in the United States has remained stable from 1998 to 2011. The rapid expansion of MI-RP has led to a considerable reduction in the open RP utilization rate, as well as to a reduction in the median annual hospital caseload.
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For editorial comment, see page 1
Grant Support: This research was supported by Desert Mountain's Cancer Awareness Through Research and Education organization (Scottsdale, Arizona), which generously supports the genitourinary research program at Mayo Clinic, Scottsdale, Arizona.