Mp33-15 Differential Receipt and Completion of a Urology Referral Subsequent to an Elevated Screening Psa Test

You have accessJournal of UrologyHealth Services Research: Quality Improvement & Patient Safety II (MP33)1 May 2024MP33-15 DIFFERENTIAL RECEIPT AND COMPLETION OF A UROLOGY REFERRAL SUBSEQUENT TO AN ELEVATED SCREENING PSA TEST Rand Wilcox Vanden Berg, Deborah Kaye, Andrew Stirling, Patti Gorgone, Shwetha Dash, Jillian Hurst, Anna Xu, Benjamin Goldstein, Armando Bedoya, Nrupen Bhavasa, Gabbriella Brenman, Hannah McManus, and Matthew Labriola Rand Wilcox Vanden BergRand Wilcox Vanden Berg , Deborah KayeDeborah Kaye , Andrew StirlingAndrew Stirling , Patti GorgonePatti Gorgone , Shwetha DashShwetha Dash , Jillian HurstJillian Hurst , Anna XuAnna Xu , Benjamin GoldsteinBenjamin Goldstein , Armando BedoyaArmando Bedoya , Nrupen BhavasaNrupen Bhavasa , Gabbriella BrenmanGabbriella Brenman , Hannah McManusHannah McManus , and Matthew LabriolaMatthew Labriola View All Author Informationhttps://doi.org/10.1097/01.JU.0001009520.30626.80.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer is the most common non-cutaneous cancer affecting men in the United States. Notably, non-Hispanic Black patients are more likely to be diagnosed with prostate cancer and have higher prostate cancer mortality compared to non-Hispanic White patients, While prostate-specific antigen (PSA) screening has been shown to decrease mortality, without a referral to the proper specialist, this benefit cannot be obtained. We analyzed the urology referral and completion of referral pattern for patients with elevated PSA screening tests at our institution and herein report factors associated with being referred for subsequent workup and the completion of such referral. METHODS: Data for patients aged 40-75 undergoing PSA screening from 1/1/2018 through 12/31/2022 were collected from institutional data. PSA results were corrected for 5-alpha reductase inhibitor use and were categorized as elevated based off of institutional policies (age 40-49, ≥ 1.5 ng/mL; 50-69, ≥ 3.0 ng/mL; ≥70, ≥ 6.5 ng/mL). Patients with elevated PSA results were then categorized as having received a referral to urology or not within 90 days of the test result. Patients that received a referral were categorized as having completed the referral if a visit was completed within our institution. Baseline characteristics were described. Multivariable log link models stratified by race were calculated for referral and completion of referral and adjusted for age, previously elevated PSA, insurance status, and healthcare utilization within prior 18 months. p values of 0.05 were considered statistically significant. RESULTS: A total of 9874 patients with elevated PSA results were included. Baseline characteristics between those that were and were not referred are presented in Table. 3250 (32.9%) were referred of which 2157 (66.4%) completed their referral internally. Modeling for receiving a referral, adjusted for age, insurance status, and prior abnormal PSA levels, showed that non-Hispanic Black patients (HR 1.426, 95% CI 1.35-1.51), Hispanic patients (HR 1.34, 95% CI 1.17-1.54), and patients with other or unavailable race (HR 1.27, 95% CI 1.17-1.39) were more likely to receive a referral when compared to non-Hispanic White patients. When looking at referral completion, however, non-Hispanic Black patients were less likely to complete the referral (HR 0.95, 95% CI 0.91-0.99); there was no difference for Hispanic patients (HR 1.05, 95% CI 0.96-1.15) or patients with other or unavailable race (HR 0.98, 95% CI 0.92-1.04). CONCLUSIONS: In our cohort, we found that when adjusting for demographic variables, Non-Hispanic Black, Hispanic, and patients reported as other were more likely to be referred for an elevated screening PSA when compared to non-Hispanic White patients. Non-Hispanic Black patients, however, were slightly less likely to complete a referral while Hispanic patients and patients reported as other were equally likely. These data suggest that more studies are needed to identify the cause of such disparate referral pattern and discover the reasons for patients not completing referrals for elevated PSA results, with the goal of establishing targeted interventions to improve urology appointment completion and ultimately patient outcomes. Source of Funding: Duke internal funds © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e566 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Rand Wilcox Vanden Berg More articles by this author Deborah Kaye More articles by this author Andrew Stirling More articles by this author Patti Gorgone More articles by this author Shwetha Dash More articles by this author Jillian Hurst More articles by this author Anna Xu More articles by this author Benjamin Goldstein More articles by this author Armando Bedoya More articles by this author Nrupen Bhavasa More articles by this author Gabbriella Brenman More articles by this author Hannah McManus More articles by this author Matthew Labriola More articles by this author Expand All Advertisement PDF downloadLoading ...