A comparison study of solid tumor, malignant hematology, and general medicine inpatient services.

Abstract

e13532 Background: One of the most important cancer centers in Ohio experienced an explosive growth in the number of inpatient admissions, with numerous inpatient services created between 2010 and 2022. In this abstract, we present how some financial and quality measures performed during this rapid expansion. Methods: Slicer-Dicer aggregate data was used to compare financial performance and quality measures of oncologic and general medicine inpatient (IP) services over time. General medicine services do not include the cancer and the heart disease populations, but there might be a small overlap. The cancer population is served by 9 IP oncology services. The following SlicerDicer Filters were used. Population: IP admissions. Slices: populations include these study groups, 10 inpatient medical oncology (solid tumors) (MO), 6 inpatient malignant hematology (MH) (including 1 bone marrow transplant) services were compared to 10 general medicine (GM) services. Gynecologic and central nervous system tumors are served by other services and were excluded. Measures: number of admissions, median and total payments (actual payment received), median and total expected reimbursement (reimbursement expected for DRG), mortality, readmission rates, average length of stay (LOS), percentage of patients with Medicaid, percentage of patients with Medicare. Dates: from 2011 to 2022 data. For some measures, quarterly data is presented rather than yearly data for graph simplicity. Results: The number of inpatient admissions grew by 90.77%, 130.55%, and 105.58% for GM, MO, and MH, respectively. The total expected reimbursement increased by 6.22%, 13.56% and decreased by 17.14% for GM, MO and MH, respectively. The total payment received grew by 314.29%, 283.69%, 86.80%, for MO, MH, and GM, respectively. MO, GM, and HM had a median payment increase of 76.51%, 51.96%, 20.74%, respectively. Mortality dropped for MO by 32.11%, from 76.9% to 52.2%, for MH by 49.46%, from 55.6% to 28.1% and in GM by 73.80% from 35.5 % to 9.3%. The average length of stay was 1 to 2 days longer in the MH and GM (respectively) compared to MO, with an increase from 2011 to 2022 for GM and MO, but a decrease for MH. Readmission rates decreased from 17.4% to 15.1% for MO, 12.7% to 10.3% for MH, and 14.9 to 12.5% for GM. In 2014, the percentage of Medicaid population increased in GM, and decreased in the oncology services (MO and MH) reaching 35% and 14% of the admitted patient population in 2022, respectively. Percentage of Medicare patients increased from 36.9% to 52.9%, 39.6% to 44.9%, and remained stable for MO, HM, and GM, respectively. Hospice discharge fluctuated between 1.2-1.6%, 2.5-5%, 8-12.9% of the discharged patients in GM, MH, and MO, respectively. Conclusions: In this abstract, we present a decade-trend data of important measures of inpatient oncology units.