Self-referral Can Increase Distance for Treatment

Photo: Doctor advise patient

Prostate cancer is the most
frequently diagnosed form of
cancer;© panthermedia.net/
Luis Louro

This study reviewed 229 urology practices in Texas and found that 5 percent (12 centers) offered radiation oncology services, and 53 percent of the state's population lives within 10 miles of these centers. The 12 urology-owned practices were found to have multiple urologic clinics, but each practice has only one radiation oncology treatment center focused on prostate cancer treatment. This often resulted in extended travel times because radiation therapy is not available at the same physical location as the urologic clinic where the patient was initially diagnosed. The mean patient travel distance was found to be 19.7 miles (26.11 minutes) to the urology-owned center versus 5.88 miles (9.15 minutes) to the nearest radiation oncology center.

The patient benefits of this practice model, known as physician self-referral, have been questioned particularly with regard to its impact on increasing health care costs. Self-referral is being investigated by the U.S. Government Accountability Office and others due to concern that financial incentives could steer patients to more costly, unnecessary and/or less effective procedures. This article reinforces concern about the increase in urology-owned radiation oncology practices across the country, and further notes that 28 percent of Texas urologists now work in practices that self-refer for radiation oncology services. According to a national Urology Times survey, 19 percent of urology groups report owning linear accelerators to provide radiation oncology treatments, and these medical groups refer patients for treatment within their own radiation oncology center.

"Integrated urology-radiation oncology practices are increasingly common in Texas and have the potential to impact patient care. For example, our study illustrates that patients diagnosed by a urologist whose practice owns a radiation treatment facility will, on average, drive three times farther to reach the radiation treatment facility owned by their urologist than they would have to drive to reach the nearest independent radiation treatment facility," said Doctor Benjamin D. Smith.

Study authors affirm that their findings are limited to their research area of the state of Texas and recommend additional analysis of how urology-owned self-referral practices affect patient care, quality of treatment and patient satisfaction and outcomes, not just patient travel time.

MEDICA.de; Source: American Society for Radiation Oncology