About Dr. Krongrad: Publications
Krongrad A, Lai H, Lai S: Hospitalization, inpatient physical therapy, and institutionalization after hospital discharge of prostate cancer patients in South Florida. J Urol 158:888-892, 1998
PURPOSE: Explaining survival variation in prostate cancer requires the identification of new predictive factors, of which physical function is attractive hypothetically. To understand physical dysfunction in prostate cancer better, we examined medical claims. Our aims were to describe the consumption of inpatient resources, examine the association of physical therapy with institutionalization after hospital discharge and determine the association of disease stage with frequency of hospitalization, inpatient physical therapy and discharge to a skilled nursing facility.
MATERIALS AND METHODS: We used 1994 Medicare claims for patients in South Florida who had prostate cancer. To examine the association of disease stage with use of health services, we inferred disease stage from stage specific treatment. Multiple linear regression was used to examine the interaction of inferred disease stage with health services while adjusting for age.
RESULTS: A total of 22,279 residents of South Florida a mean of 78.3 years old with prostate cancer billed Medicare in 1994. Of these patients 2,507 were admitted to a hospital 4,606 times, resulting in total charges of $70 million. Many claims indicated physical dysfunction, including 1,896 charges for physical therapy, which was associated with more institutionalization after hospital discharge. Disease stage and patient age were individually associated with the frequency of hospitalization, inpatient physical therapy and discharge to a skilled nursing facility.
CONCLUSIONS: Inpatients with prostate cancer have substantial stage dependent physical dysfunction. If the hypothesized interaction of physical dysfunction with mortality is confirmed in prospective studies and outpatient settings, theoretically the door will have been opened to new interventions for prolonging survival in patients with prostate cancer.