Continuity of care in acute survivorship phase, and short and long-term outcomes in prostate cancer patients

Prostate. 2021 Dec;81(16):1310-1319. doi: 10.1002/pros.24228. Epub 2021 Sep 13.


Continuity of care is important for prostate cancer care due to multiple treatment options, and prolonged disease history. We examined the association between continuity of care and outcomes in Medicare beneficiaries with localized prostate cancer, and the moderating effect of race using Surveillance, Epidemiological, and End Results (SEER) - Medicare data between 2000 and 2016. Continuity of care was measured as visits dispersion (continuity of care index or COCI), and density (usual provider care index or UPCI) in acute survivorship phase. Outcomes were emergency room visits, hospitalizations, and cost during acute survivorship phase and mortality (all-cause and prostate cancer-specific) over follow-up phase. Higher continuity of care was associated with improved outcomes, and interaction between race and continuity of care was significant. Continuity of care during acute survivorship phase may lower the racial disparity in prostate cancer care. Future research can analyze the mechanism of the process.

Keywords: SEER-Medicare database; continuity of care; cost of care; health service use; localized prostate cancer; mortality; race disparity.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aftercare* / methods
  • Aftercare* / statistics & numerical data
  • Age Factors
  • Aged
  • Ambulatory Care / statistics & numerical data
  • Cancer Survivors / statistics & numerical data*
  • Continuity of Patient Care* / organization & administration
  • Continuity of Patient Care* / statistics & numerical data
  • Emergency Medical Services / methods
  • Emergency Medical Services / statistics & numerical data
  • Healthcare Disparities / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Male
  • Medicare / economics
  • Medicare / statistics & numerical data
  • Prostatic Neoplasms* / ethnology
  • Prostatic Neoplasms* / therapy
  • SEER Program / statistics & numerical data*
  • Time*
  • United States / epidemiology