To characterize penile prosthesis surgery utilization and assess for regional differences in the use of this procedure across the United States.
We examined penile prosthesis surgeries (inflatable and semi-rigid implants) in Medicare beneficiaries with ED for the years 2006 through 2014.
Adjusted utilization rates were calculated per 1000 beneficiaries accounting for age and race. Utilization rates were examined nationally and by hospital referral region (HRR).
The national adjusted rate of penile prosthesis surgery declined from 5.41 per 1000 beneficiaries in 2006 to 3.74 per 1000 beneficiaries in 2014. The number of beneficiaries diagnosed with ED outpaced the number of patients undergoing surgery. Regional variation was observed; a 12-fold difference in 2014 (1.9/1000 in Norfolk, VA to 24.2/1000 in Miami, FL). Adjustment of 2014 data by urology provider density reduced variation between HRRs, and as a result a 3.5-fold difference was observed. Over 60% of HRRs performed zero to < 11 surgeries.
The rate of penile prosthesis surgery is declining amongst Medicare beneficiaries with ED. Significant regional variation exists in the utilization of penile prosthesis surgery. This variation may be explained by a series of urologist and patient-specific factors, including provider density. Penile prosthesis surgery in Medicare beneficiaries is likely highly dependent on where these patients seek care.
Urology. 2020 Apr 13 [Epub ahead of print]
Michael E Rezaee, Briana Goddard, Ricardo M Munarriz, Martin S Gross
Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756. Electronic address: ., Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH 03755. Electronic address: ., Department of Urology, Boston University Medical Center, 725 Albany St, 3(rd) Floor, Suite B, Boston, MA, 02118. Electronic address: ., Section of Urology, Department of Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/32298685