Volume-Outcomes in Incontinence Surgery

Summary

Principal Investigator: Jennifer T Anger
Abstract: Few studies have examined quality of care in the management of urinary incontinence. Volume, or case load, has been used as a surrogate for quality of care in many diseases and is easily analyzed. Major Hypothesis: Provider volume affects outcomes following pubovaginal sling surgery. Aim 1: To determine whether surgeon volume is associated with short-term outcomes after sling surgery among female Medicare beneficiaries. Aim 2: To determine whether hospital volume is associated with short-term outcomes. Aim 3: To determine whether the interaction between surgeon and hospital volume is associated with short-term outcomes after sling surgery. A 5% national random sample of 1999-2002 claims data from Public Use Files provided by the Centers for Medicare and Medicaid Services will be analyzed. Women undergoing pubovaginal sling procedures will be identified on the basis of the presence of either International Classification of Diseases (ICD-9) codes or Physicians Current Procedural Terminology (CPT-4) codes and tracked for 12 months. The primary outcome will be re-operation rates, repeat sling procedures (for failures), and other postoperative complications, stratified by high and low volume surgeons and hospitals.
Funding Period: 2005-09-08 - 2006-09-07
more information: NIH RePORT

Top Publications

  1. ncbi Complications of sling surgery among female Medicare beneficiaries
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, California 90095, USA
    Obstet Gynecol 109:707-14. 2007
  2. ncbi The role of provider volume on outcomes after sling surgery for stress urinary incontinence
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California Los Angeles, Los Angeles, California 90095, USA
    J Urol 177:1457-62; discussion 1462. 2007
  3. ncbi Racial disparities in the surgical management of stress incontinence among female Medicare beneficiaries
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California Los Angeles, Los Angeles, California 90095 1738, USA
    J Urol 177:1846-50. 2007
  4. ncbi Variations in stress incontinence and prolapse management by surgeon specialty
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine, School of Public Health, University of California Los Angeles, Los Angeles, California 90404, USA
    J Urol 178:1411-7. 2007
  5. ncbi The role of preoperative testing on outcomes after sling surgery for stress urinary incontinence
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, CA 90404, USA
    J Urol 178:1364-8; discussion 1368-9. 2007
  6. ncbi The effect of age on outcomes of sling surgery for urinary incontinence
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, California 90404, USA
    J Am Geriatr Soc 55:1927-31. 2007
  7. ncbi The effect of concomitant prolapse repair on sling outcomes
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, Los Angeles, California 90404, USA
    J Urol 180:1003-6. 2008
  8. pmc Thromboembolic complications of sling surgery for stress urinary incontinence among female Medicare beneficiaries
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, California 90095 1738, USA
    Urology 74:1223-6. 2009

Scientific Experts

Detail Information

Publications8

  1. ncbi Complications of sling surgery among female Medicare beneficiaries
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, California 90095, USA
    Obstet Gynecol 109:707-14. 2007
    ..To analyze Medicare claims data to determine short-term complications after sling surgery among female beneficiaries aged 65 years and over...
  2. ncbi The role of provider volume on outcomes after sling surgery for stress urinary incontinence
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California Los Angeles, Los Angeles, California 90095, USA
    J Urol 177:1457-62; discussion 1462. 2007
    ..We ascertained whether this relationship held in sling surgery for urinary incontinence...
  3. ncbi Racial disparities in the surgical management of stress incontinence among female Medicare beneficiaries
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California Los Angeles, Los Angeles, California 90095 1738, USA
    J Urol 177:1846-50. 2007
    ..The relationship between urinary incontinence and race/ethnicity is poorly understood. We analyzed Medicare claims data to identify racial differences in the diagnosis, treatment and outcomes of women with stress urinary incontinence...
  4. ncbi Variations in stress incontinence and prolapse management by surgeon specialty
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine, School of Public Health, University of California Los Angeles, Los Angeles, California 90404, USA
    J Urol 178:1411-7. 2007
    ..In this study we sought to determine the effect of surgeon specialty on outcomes of sling surgery for women with stress urinary incontinence...
  5. ncbi The role of preoperative testing on outcomes after sling surgery for stress urinary incontinence
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, CA 90404, USA
    J Urol 178:1364-8; discussion 1368-9. 2007
    ..In this study we analyzed Medicare claims data to measure the effect of preoperative urodynamics and cystoscopy on outcomes after sling surgery...
  6. ncbi The effect of age on outcomes of sling surgery for urinary incontinence
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, California 90404, USA
    J Am Geriatr Soc 55:1927-31. 2007
    ..To measure the effect of patient age on outcomes of sling surgery for stress urinary incontinence...
  7. ncbi The effect of concomitant prolapse repair on sling outcomes
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, Los Angeles, California 90404, USA
    J Urol 180:1003-6. 2008
    ..We analyzed the effect of concomitant prolapse surgery performed at the time of sling surgery on short-term postoperative outcomes in women with urinary incontinence...
  8. pmc Thromboembolic complications of sling surgery for stress urinary incontinence among female Medicare beneficiaries
    Jennifer T Anger
    Department of Urology, David Geffen School of Medicine and School of Public Health, University of California, Los Angeles, California 90095 1738, USA
    Urology 74:1223-6. 2009
    ..To determine the rate of thromboembolic complications after sling surgery for stress urinary incontinence among female Medicare beneficiaries aged 65 and older...