Impact of Prostate Cancer Diagnosis on Noncancer Hospitalizations Among Elderly Medicare Beneficiaries With Incident Prostate Cancer

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Amit D. Raval From the Department of Pharmaceutical Systems and Policy, School of Pharmacy, and the Departments of Radiation Oncology and Urology, School of Medicine, West Virginia University, Morgantown, West Virginia.

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Suresh Madhavan From the Department of Pharmaceutical Systems and Policy, School of Pharmacy, and the Departments of Radiation Oncology and Urology, School of Medicine, West Virginia University, Morgantown, West Virginia.

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Malcolm D. Mattes From the Department of Pharmaceutical Systems and Policy, School of Pharmacy, and the Departments of Radiation Oncology and Urology, School of Medicine, West Virginia University, Morgantown, West Virginia.

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Mohamad Salkini From the Department of Pharmaceutical Systems and Policy, School of Pharmacy, and the Departments of Radiation Oncology and Urology, School of Medicine, West Virginia University, Morgantown, West Virginia.

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Usha Sambamoorthi From the Department of Pharmaceutical Systems and Policy, School of Pharmacy, and the Departments of Radiation Oncology and Urology, School of Medicine, West Virginia University, Morgantown, West Virginia.

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Objectives: The purpose of this study was to analyze the impact of cancer diagnosis on noncancer hospitalizations (NCHs) by comparing these hospitalizations between the precancer and postcancer periods in a cohort of fee-for-service Medicare beneficiaries with incident prostate cancer. Methods: A population-based retrospective cohort study was conducted using the SEER-Medicare linked database for 2000 through 2010. The study cohort consisted of 57,489 elderly men (aged ≥67 years) with incident prostate cancer. NCHs were identified in 6 periods (t1–t6) before and after the incidence of prostate cancer. Each period consisted of 120 days. For each period, NCHs were defined as inpatient admissions with primary diagnosis codes not related to prostate cancer, prostate cancer–related procedures, or bowel, sexual, and urinary dysfunction. Bivariate and multivariate comparisons on rates of NCHs between the precancer and postcancer periods accounted for the repeated measures design. Results: The rate of NCHs was higher during the postcancer period (5.1%) compared with the precancer period (3.2%). In both unadjusted and adjusted models, elderly men were 37% (odds ratio [OR], 1.37; 95% CI, 1.32, 1.41) and 38% (adjusted OR, 1.38; 95% CI, 1.33, 1.46) more likely to have any NCHs during the postcancer period compared with the precancer period. Conclusions: Elderly men with prostate cancer had a significant increase in the risk of NCHs after the diagnosis of prostate cancer. This study highlights the need to design interventions for reducing the excess NCHs after prostate cancer diagnosis among elderly men.

Correspondence: Amit D. Raval, PhD, Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, P. O. Box 9510, Morgantown, WV 26506. E-mail: amitraval.heor.wvu@gmail.com

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