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Qian Z, Chen YJ, Moman P, Labban M, Stelzl D, Dagnino F, Zurl H, Daniels D, Carranza C, Watts KL, Cole AP, Trinh QD. Identifying Barriers to Timely Follow-up After Elevated PSA Screening: A Retrospective Analysis of a Large Healthcare System. Urology 2024:S0090-4295(24)00714-3. [PMID: 39208942 DOI: 10.1016/j.urology.2024.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/01/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To examine elevated PSA follow-up within our system and identify areas for improvement in the timely diagnosis of prostate cancer. METHODS We queried the Mass General Brigham's Enterprise Data Warehouse from 2018-2021, identifying patients with elevated PSA and documented time to follow-up. Timely follow-up was defined as having a urologist appointment, prostate biopsy, or prostate magnetic resonance imaging within 6 months from diagnosis. We stratified the location of elevated PSA diagnosis to academic medical centers versus community sites. Univariable and multivariable analyses were performed to identify factors impacting follow-up. RESULTS We included 28,346 patients, with 50.30%, 15.02%, and 34.69% receiving timely, untimely, and no follow-up during the study period, respectively. In multivariable analysis, patients seen at academic medical centers were more likely to receive follow-up care (OR=1.39, 95%CI 1.30-1.48). In a sensitivity analysis including 2 of our largest community hospitals as part of academic medical facilities, those following up at our main sites showed even higher odds of timely follow-up (OR=1.61, 95%CI 1.51-1.73). CONCLUSION Our study observed variations in follow-up rate between our academic medical centers and community sites. This finding highlights the need for efforts to improve consistency and timeliness of prostate cancer follow-up care across all facilities. By addressing interfacility disparities, we can facilitate the delivery of timely care to all patients.
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Affiliation(s)
- Zhiyu Qian
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Yu-Jen Chen
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Precious Moman
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Muhieddine Labban
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Daniel Stelzl
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Filippo Dagnino
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Hanna Zurl
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Danesha Daniels
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Claudia Carranza
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Kara L Watts
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Alexander P Cole
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Quoc-Dien Trinh
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
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Zephyrin L, Ayo-Vaughan M, Bossick A, Noroña-Zhou A, Higginbotham E, Richardson M, Rodriguez H, Bryant A. Stakeholders' Viewpoints on Working to Advance Health Equity. Health Equity 2024; 8:14-25. [PMID: 38304261 PMCID: PMC10833320 DOI: 10.1089/heq.2023.29040.rtd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Affiliation(s)
- Laurie Zephyrin
- Senior Vice President, Advancing Health Equity, The Commonwealth Fund, New York, New York, USA
| | - Morenike Ayo-Vaughan
- Program Officer, Advancing Health Equity, The Commonwealth Fund, New York, New York, USA
| | - Andrew Bossick
- Assistant Scientist, Henry Ford Health, Detroit, Michigan, USA
| | - Amanda Noroña-Zhou
- Assistant Director of Developmental Medicine, University of California, San Francisco, California, USA
| | - Eve Higginbotham
- Vice Dean for Inclusion, Diversity, and Equity, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Molly Richardson
- Visiting Assistant Professor, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Hector Rodriguez
- Kaiser Permanente Endowed Professor of Health Policy and Management, University of California, Berkeley, School of Public Health, Berkeley, California, USA
| | - Allison Bryant
- Maternal-Fetal Medicine Specialist, Associate Chief Health Equity Officer, Massachusetts General Hospital, Boston, Massachusetts, USA
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