Korean J Urol.  2015 Mar;56(3):233-239. 10.4111/kju.2015.56.3.233.

Comparative analysis of benign prostatic hyperplasia management by urologists and nonurologists: A Korean nationwide health insurance database study

• Park J
• Lee YJ
• Lee JW
• Yoo TK
• Chung JI
• Yun SJ
• Hong JH
• Seo SI
• Cho SY
• Son H

• KMID: 2133292
• DOI: http://doi.org/10.4111/kju.2015.56.3.233

Abstract

PURPOSE
To compare the current management of benign prostatic hyperplasia (BPH) by urologists and nonurologists by use of Korean nationwide health insurance data.
MATERIALS AND METHODS
We obtained patient data from the national health insurance system. New patients diagnosed with BPH in 2009 were divided into two groups depending on whether they were diagnosed by a urologist (U group) or by a nonurologist (NU group).
RESULTS
A total of 390,767 individuals were newly diagnosed with BPH in 2009. Of these, 240,907 patients (61.7%) were in the U group and 149,860 patients (38.3%) were in the NU group. The rate of all initial evaluation tests, except serum creatinine, was significantly lower in the NU group. The initial prescription rate was higher in the U group, whereas the prescription period was longer in the NU group. Regarding the initial drugs prescribed, the use of alpha-blockers was common in both groups. However, the U group was prescribed combination therapy of an alpha-blocker and 5-alpha-reductase inhibitor as the second choice, whereas the NU group received monotherapy with a 5-alpha-reductase inhibitor. During the 1-year follow-up, the incidence of surgery was significantly different between the U group and the NU group.
CONCLUSIONS
There are distinct differences in the diagnosis and treatment of BPH by urologists and nonurologists in Korea. These differences may have adverse consequences for BPH patients. Urological societies should take a leadership role in the management of BPH and play an educational role for nonurologists as well as urologists.

Keyword

Epidemiology; Insurance claim review; Prostatic hyperplasia

MeSH Terms

5-alpha Reductase Inhibitors/therapeutic use
Adrenergic alpha-Antagonists/therapeutic use
Adult
Age Distribution
Aged
Aged, 80 and over
Databases, Factual
*Disease Management
Humans
Insurance, Health
Linear Models
Male
Middle Aged
Physicians
Prostatic Hyperplasia/*diagnosis/*therapy
Republic of Korea
Urology/*methods
Young Adult
5-alpha Reductase Inhibitors
Adrenergic alpha-Antagonists

Figure

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  Fig. 1 Initial prescription pattern of newly diagnosed benign prostatic hyperplasia patients in 2009. (A) Total cases of prescription by U group vs. NU group. (B) Venn diagrams of prescription pattern of U group vs. NU group. U group, patients diagnosed by a urologist; NU group, patients diagnosed by a nonurologist.

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