Faculty Publications

Impact Of Malpractice Caps On Use And Outcomes Of Radical Cystectomy For Bladder Cancer: Data From The Surveillance, Epidemiology, And End Results Program

Document Type

Article

Keywords

Bladder, Bladder neoplasms, Cystectomy, Epidemiology, SEER program

Journal/Book/Conference Title

Journal of Urology

Volume

173

Issue

6

First Page

2085

Last Page

2089

Abstract

Purpose: The impact of malpractice awards on insurance premiums and health care delivery generates much concern. To our knowledge no data exist regarding the impact of caps, or upper limits, on awards for noneconomic damages (also termed pain and suffering) on health care delivery patterns or outcomes. We investigated the effect of caps on the use of and outcomes following aggressive surgical treatment (radical cystectomy) in patients with bladder cancer. Materials and Methods: We performed a retrospective cohort study of patients with bladder cancer who underwent radical cystectomy, identified from the Surveillance, Epidemiology, and End Results (SEER) Program database. Cystectomy rates and post-cystectomy disease specific survival were compared between SEER regions with and without a cap, while controlling for other variables. Results: A significantly greater proportion of patients with stages III and IV bladder cancer underwent cystectomy in SEER regions with a cap. Cap status was a significant predictor of survival from bladder cancer. Conclusions: Radical cystectomy for bladder cancer is performed more often even for advanced bladder cancer in geographic regions with a cap with a positive impact on survival. The institution of caps may have beneficial effects on patterns of health care beyond that of merely decreasing insurance premium costs. Copyright © 2005 by American Urological Association.

Department

School of Health, Physical Education, and Leisure Services

Original Publication Date

1-1-2005

DOI of published version

10.1097/01.ju.0000158137.30303.65

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