MP76-13 PROSTATE BIOPSY COSTS FOR PRIVATELY-INSURED MEN: IMPACT OF MAGNETIC RESONANCE IMAGE-GUIDANCE AND USE OF ANESTHESIA SERVICES
Notice bibliographique
Résumé
You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Value of Care: Cost & Outcomes Measures I1 Apr 2018MP76-13 PROSTATE BIOPSY COSTS FOR PRIVATELY-INSURED MEN: IMPACT OF MAGNETIC RESONANCE IMAGE-GUIDANCE AND USE OF ANESTHESIA SERVICES Andrew Leung, Wen Liu, Dattatraya Patil, Mark Henry, David Howard, Heqiong Wang, Renee Moore, Martin Sanda, and Christopher Filson Andrew LeungAndrew Leung More articles by this author , Wen LiuWen Liu More articles by this author , Dattatraya PatilDattatraya Patil More articles by this author , Mark HenryMark Henry More articles by this author , David HowardDavid Howard More articles by this author , Heqiong WangHeqiong Wang More articles by this author , Renee MooreRenee Moore More articles by this author , Martin SandaMartin Sanda More articles by this author , and Christopher FilsonChristopher Filson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2581AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate biopsy technique is evolving, with use of magnetic resonance imaging (MRI) guidance and anesthesia services becoming more common. We evaluated the cost impact of these changes among biopsies for privately-insured men in the United States. METHODS Using MarketScan Commercial Claims database, we identified biopsies performed from 2009-2015 with appropriate procedure codes. Pertinent payments were identified within a 21-day window surrounding each biopsy claim and 7-day window surrounding any MRI claim. We assigned MRI-guidance if pelvic MRI was done within 3 months prior to biopsy. Receipt of anesthesia (CPT 00100-01999) or sedation (CPT 99143-99145; 99148-99150) was identified. All pertinent pathology services were captured. Patient cost-sharing was based on copayments and deductibles. Overall and component median payments were identified and compared with appropriate parametric testing. RESULTS We identified 311,517 biopsies that were MRI-guided (n=6,888), ultrasound-guided (n=302,449), or transperineal (n=2,180). Over 14% of biopsies were with general anesthesia, more commonly if MRI-guided (22%) or transperineal (82%). Median payments were highest for MRI-guided biopsies ($4356, IQR $2699-7153), followed by transperineal ($2671, IQR 1793-4213) and ultrasound-guided biopsies ($1842, IQR $1274-2600) (p<0.001) (Figure). Patient cost sharing was also greater with MRI-guided biopsies ($346 vs $180 ultrasound-guided, p<0.001) and transperineal biopsies ($255 vs $180, p<0.001). For MRI-guided biopsies, median imaging costs were significantly greater ($1417 vs $294 ultrasound-guided, p<0.001). Median payments for anesthesia services were $528 (IQR $240-892), $270 (IQR $60-464), and $503 (IQR $394-682) for MRI-guided, ultrasound-guided, and transperineal biopsies, respectively. CONCLUSIONS Median payments for MRI-guided biopsies were over twice as great as those for traditional ultrasound-guided biopsies, with the differences in payments being driven mainly by imaging costs. These findings have important implications as efforts focus on delivery of high-value services used for prostate cancer detection. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1023 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Andrew Leung More articles by this author Wen Liu More articles by this author Dattatraya Patil More articles by this author Mark Henry More articles by this author David Howard More articles by this author Heqiong Wang More articles by this author Renee Moore More articles by this author Martin Sanda More articles by this author Christopher Filson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,020 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».