Increase in Cost of Inpatient Stay for Patients With Prostate Cancer - Journal of Clinical Pathways

Increase in cost of inpatient stay for patients with prostate cancer is likely due to advances in multi-modality treatment, according to a study presented at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium (February 14-16, 2019; San Francisco, CA).

Given the complexity of health care costs, more variables should be considered to rationalize health care spending, the study also contends.

While efforts from the Centers for Medicare and Medicaid Services (ie, close monitoring of length of inpatient stay) are in place to curtail costs of care for patients with cancer, the economic burden of novel treatments is becoming increasingly apparent. In prostate cancer, SEER analysis shows a 5-year overall survival of 98.2% and incidence of 179.1 in 2000 compared with 97.8% in 2015 per 100,000, respectively. However, this result is accompanied by increasing health care costs.

Dhruv Bansal, MD, and John Wong, MD, both with Loma Linda University Medical Center (CA), conducted an analysis to evaluate trends in prostate cancer cost of care as well as traditional cost control measures. Researchers utilized the National Inpatient Sample database to sample data for patients hospitalized with a primary diagnosis of prostate cancer from 2000 through 2014.

Drs Bansal and Wong focused their analysis on mean length of stay, mean cost of hospitalization, and rate of discharge.

Results of the analysis showed the discharge rate was 32.2 (+/- 1.3) in 2000 vs 20.4 (+/- 0.8) in 2014 per 100,000, respectively. Similarly, mean length of stay decreased from 3.7 days (+/- 0.115) in 2000 to 2.2 days (+/- 0.044) in 2014. In this same time frame, mean hospitalization charges increased from $14,680 (+/- 466) to $49,464 (+/- 1019), respectively.

Researchers also accounted for inflation during this time; the average annual inflation rate over this 15-year span was 2.26%. After adjusting for inflation, the mean cost of inpatient stay in 2000 was $20,072 compared with $49,464 in 2014. This trend is even more apparent when analyzing cost per day of hospitalization ($5424 vs $22,482, respectively).

“With the aging population and focus on cost conscious allocation of resources, this increase in costs will remain a challenge for hospital decision makers and insurance companies,” Drs Bansal and Wong concluded. “Complex analyses might be feasible with advances in deep learning which enable consideration of multiple variables in the decision-making process.”—Zachary Bessette

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