Health Services Research

PV QA 3 - Poster Viewing Q&A 3

TU_41_3001 - The Downstream "Halo" Effect of a Proton Therapy Center on an Academic Medical Center

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

The Downstream “Halo” Effect of a Proton Therapy Center on an Academic Medical Center
J. Remick1, A. M. Chhabra1, S. M. Bentzen2, C. B. Simone II3, E. M. Nichols3, M. Suntharalingam4, and W. F. Regine Jr5; 1Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD, 2Greenebaum Comprehensive Cancer Center and Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, 3Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, 4University of Maryland, Baltimore, MD, 5University of Maryland School of Medicine, Baltimore, MD

Purpose/Objective(s): To evaluate downstream effects of a proton center (PC) on a radiation oncology (RO) department and academic medical center (AMC). We hypothesized the opening of our PC would increase AMC and photon RO patient care activity, expand research funding and enhance residency education.

Materials/Methods: The impact of a new PC on patient care volume/revenue, education and research funding were evaluated from fiscal year 2015 (FY15) through FY 2017 (FY17). Relative value units (RVU) per FY were used to assess total activity at our main AMC RO photon and our departmental RO Community Based Centers (CBCs). The time period was chosen to include 1 year prior (FY15) to the PC opening through last completed FY (FY17). Data was obtained from institutional grant office and hospital patient tracking/billing systems for main campus AMC and our two CBCs with PC faculty members. To determine the effect on the AMC, we reviewed the electronic medical record (EMR) for all patients seen at PC where consults were initiated in November 2015 (n=1,173). In order to isolate first point of entry into the AMC through PC, patients were excluded if the date of entry into the AMC EMR pre-dated their first visit at PC/if referred by an AMC faculty physician (n= 612).

Results: A total of 561 patients met inclusion criteria. Of these, 31% were self-referred, 31% were referred from within state and 38% referred from out of state. The most common referring specialties were RO (36%), medical oncology (15%) and urology (8%). The most common primary diagnoses were prostate (29%), CNS (14%) and breast (12%). Interventional or RO procedures at the AMC were performed for 18% and 5% of patients, respectively. AMC medical oncology and surgical referrals were provided to 13% and 5% of patients, respectively. Inpatient admission or emergency room visits occurred in 7% and 5% of patients, respectively. These patients generated total AMC hospital charges of $2.38 million and total AMC professional collection of $767,328. From FY16-FY17 total treatment fractions at our PC increased from 1,656 to 12,380. From FY15-FY17, fractions and RVUs at AMC RO decreased by 14% and 5%, respectively. From FY15-FY17, fractions at our two CBCs increased by 2% and 19%, and RVUs increased by 4% and 27%. Overall, combined photon (AMC and CBCs) daily fractions and RVUs decreased 0.2% and increased 5%, respectively. Resident educational experience demonstrated an increase in pediatric and prostate case volume from 29 and 44 in FY15 to 38 and 144 in FY17, respectively (our AMC is in close proximity to a large Urology owned RO center). Regarding proton therapy related research, 17 grant applications totaling $13.36 million to NIH (6), non-NIH federal (6) and other potential funding agencies (5) were submitted, with 6 grants already awarded totaling $3.26 million.

Conclusion: Despite a slight decline in our AMC RO RVUs, there has been a positive downstream halo effect associated with our PC that has benefited our overall AMC, RO department, educational and funded research experiences.

Author Disclosure: J. Remick: None. A.M. Chhabra: None. S.M. Bentzen: Travel Expenses; University of Copenhagen. C.B. Simone: Employee; Nemours/Alfred I. duPont Hospital for Children. Chair, Executive Council; Chair, Lung Committee; Proton Collaborative Group (PCG). Editor-in-Chief; Annals of Palliative Medicine. Chair, Lung Resource Panel; American Society for Radiation Oncology. E.M. Nichols: Clinical Director; Department of Radiation Oncology. M. Suntharalingam: President and CEO; University of Maryland Medical Center. W.F. Regine: Honoraria; Varian. Patent/License Fees/Copyright; GammaPod. Chairman; UMMC, SOM.

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