Healthcare use and costs of primary and secondary care patients with prostatitis

Objectives. To examine and identify predictors of healthcare use and prostatitis-related and total healthcare costs for primary and secondary care patients with new episodes of care for prostatitis. Methods. We compared the use and costs for 270 men with a new episode of care for prostatitis to those of randomly selected male health maintenance organization enrollees matched by age and primary care provider. We examined the episode of care (index visit and next 2 months) and the previous and subsequent years. Patients with prostatitis were interviewed 1 month after the index visit. Results. Compared with controls, patients with prostatitis had significantly greater total healthcare use (P < 0.001) and costs (P < 0.05) in each period. The prostatitis costs were only a small proportion of the total costs of the patients with prostatitis and of the difference in costs between patients with prostatitis and controls. The 10% of patients with prostatitis with the greatest total costs accounted for about one half of all costs. White race (P = 0.04), less education (P = 0.02), greater disability (P = 0.003), and greater number of non-pelvic pain sites (P = 0.004) at baseline predicted greater total healthcare costs after the index visit. Conclusions. Health maintenance organization enrollees who seek care for prostatitis have greater total healthcare use and costs than do other enrollees of the same age and primary care provider. Most of the difference in costs reflects care for problems other than prostatitis. A small proportion of patients account for most of the costs. (C) 2004 Elsevier Inc.