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Medicare & Medicaid Research Review

Title
Linkages Between Utilization of Prostate Surgical Pathology Services and Physician Self-Referral
First Author
Mitchell, Jean M.
Date of Article
2012 Q3

Full Titles: Linkages Between Utilization of Prostate Surgical Pathology Services and Physician Self-Referral

Volume: 2012

Issue: Q3

Findings: Regression analysis shows the self-referral share (percentage) of total utilization was associated with significant increases in the use rate of prostate surgical pathology specimens (p<.01). The use rate of prostate surgical pathology specimens (jars) would be 41.5 units higher in a county where the self-referral share of total utilization was 50% compared to a county with no self-referral (share equals 0%).

Conclusions: The findings show that urologist self-referral of prostate surgical pathology services results in increased utilization and higher Medicare spending. The results suggest that exceptions in federal and state self-referral prohibitions need to be reevaluated.

Keywords: Prostate Biopsies, Surgical Pathology Services, Urologist Self-Referral

doi: http://dx.doi.org/10.5600/mmrr.002.03.a02