Improving appropriate selection of radical prostatectomy for prostate cancer

Men 70 and older should usually not have radical prostatectomies to treat prostate cancer. Using Medicare claims data, 10 hospitals were identified that performed 29% of the radical prostatectomies in men 70 and older in Kentucky and Indiana. A quality improvement project was conducted with the purpose of decreasing the performance of radical prostatectomy in men 70 and older. On the advice of an expert committee, the peer review organization and the 10 hospitals collaborated in developing and implementing improvement plans that included institutional review of practices and informed consent policies. The project was associated with significant improvement in the use of radical prostatectomy. In addition, substantial savings in Medicare payments were observed, and improvement in the quality of life for Medicare men was anticipated.