Is Race Associated with the Surgical Treatment for Benign Prostatic Hyperplasia? An Analysis of 30,000 Medicare Lives

Backgrounds With an increased prevalence and burden of benign prostatic hyperplasia (BPH), effective and equitable treatment is a priority. Limited data exist evaluating treatment disparities for patients with BPH by race. This study examined the association between race and BPH surgical treatment rates among Medicare beneficiaries. Methods Medicare claims data were used to identify men newly diagnosed with BPH from January 1, 2010 through December 31, 2018. Patients were followed until their first BPH surgery, a diagnosis of prostate/bladder cancer, termination of Medicare enrollment, death, or end of study. Cox proportional hazards regression compared the likelihood of BPH surgery between men of different races (White vs. Black, Indigenous, and People of Color (BIPOC)), controlling for patients' geographical region, Charlson comorbidity score, and baseline comorbidities. Results The study included 31,699 patients (13.7% BIPOC). BIPOC men had significantly lower BPH surgery rates (9.5% BIPOC vs. 13.4% White; p=0.02). BIPOC race was associated with a 19% lower likelihood of receiving BPH surgery than White race (HR, 0.81; 95% CI 0.70, 0.94). Transurethral resection of the prostate was the most common surgery for both groups (49.4% Whites vs. 56.8% BIPOC; p=0.052). A higher proportion of BIPOC men underwent procedures in inpatient settings compared to White men (18.2% vs. 9.8%; p<0.001). Conclusions Among a cohort of Medicare beneficiaries with BPH, there were notable treatment disparities by race. BIPOC men had lower rates of surgery than White men and were more likely to undergo procedures in the inpatient setting. Improving patient access to outpatient BPH surgical procedures may help address treatment disparities

General surgery · Hyperplasia · Pathology · Public health · Quality of Life Research · Race (biology · Sociology · Gender Studies · Hormonal and reproductive studies · Medicine · Prostate Cancer Diagnosis and Treatment · Urinary Bladder and Prostate Research · Epidemiology · Gerontology · Internal Medicine

• Validating recommendations for coronary angiography following acute myocardial infarction in the elderly

  Open Access•Sharon‐Lise T Normand, Sharon-Lise T Normand et al.•Journal of Clinical Epidemiology•2001

  Add to list

• Updating and Validating the Charlson Comorbidity Index and Score for Risk Adjustment in Hospital Discharge Abstracts Using Data From 6 Countries

  Hude Quan, Bing Li et al.•American Journal of Epidemiology•2011

  Add to list

• Coding Algorithms for Defining Comorbidities in ICD-9-CM and ICD-10 Administrative Data

  Hude Quan, Vijaya Sundararajan et al.•Medical Care•2005

  Add to list