Bridging the Gap Between Research and Health Policy – Insights From Robert Wood Johnson Foundation Clinical Scholars
Physician Social Networks and Variation in Prostate Cancer Treatment in Three Cities
Article first published online: 18 OCT 2011
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 1pt2, pages 380–403, February 2012
How to Cite
Pollack, C. E., Weissman, G., Bekelman, J., Liao, K. and Armstrong, K. (2012), Physician Social Networks and Variation in Prostate Cancer Treatment in Three Cities. Health Services Research, 47: 380–403. doi: 10.1111/j.1475-6773.2011.01331.x
- Issue published online: 12 JAN 2012
- Article first published online: 18 OCT 2011
- Center for Population Health and Health Disparities. Grant Number: P50-CA105641
- National Cancer Institute. Grant Numbers: 5U54CA091409-10, 1K07CA151910-01A1
- Physician networks;
- physician referral;
- network analysis;
- prostate cancer
To examine whether physician social networks are associated with variation in treatment for men with localized prostate cancer.
2004–2005 Surveillance, Epidemiology and End Results-Medicare data from three cities.
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.
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.
Using claims data to identify physician networks may provide an insight into the observed variation in treatment patterns for men with prostate cancer.