ALL-240: Hospitalizations Following Hematologic Malignancy Diagnosis: National Values for Rates, Duration, and Charges

Abstract

Context Individuals with hematologic malignancies are frequently hospitalized in the first year following diagnosis. Hospitalizations may represent substantial financial burdens to patients. Objective To examine national patterns of hospitalization among individuals with hematologic cancers. Design SEER-Medicare retrospective analysis. Setting Individuals with Medicare diagnosed with hematologic malignancies while residing in SEER regions of the U.S., covering approximately 28% of the U.S. population. Patients All individuals diagnosed with leukemia, non-Hodgkin lymphoma (NHL), or multiple myeloma (MM) in SEER-Medicare in the most recent 5 years of data available, 2011-2015. Patients in Medicare fee-for-services who survived >12 months following diagnosis were included. The study included 23,419 unique patients: 12,147 with NHL, 6621 with leukemia, and 4651 with MM. Interventions None. Main outcome measures Rate, frequency, duration, and costs of hospitalizations by cancer type and patient sociodemographic characteristics. Costs presented in 2016 US dollars. Results More than two-thirds (15,816; 67.5%) of patients were hospitalized at least once in the first year following diagnosis. Rates of any hospitalization during this period ranged from 49.9% for CLL and 62.8% for extranodal NHL to 91.1% for ALL and 95.2% AML. There were no significant differences in hospitalization rates by sex; rates were higher for older patients among CLL, CML, and NHL populations. Hospitalization rates varied significantly by race/ethnicity only for CLL (higher among Black patients). For patients with >1 hospitalization, mean number of hospitalizations ranged from 2.25 for CLL and 2.34 for CML to 4.02 for AML and 6.40 for ALL. Average days-per-hospitalization were lower for NHL patients (8.44) than for MM (10.46) or leukemia patients (ranging from 9.37 for other lymphocytic leukemia to 12.99 for AML). Average total 12 month Medicare hospital reimbursements and patient charges were lowest for other lymphocytic leukemia ($117,786; $2070), highest for ALL ($858,276; $8298). Conclusions Most Medicare beneficiaries with hematologic malignancies experience at least one hospitalization within 12 months of diagnosis. Rate, number, duration, and charges of hospitalizations varied by cancer type, but there was little variation in hospitalization rate by patient sociodemographic characteristics. This nationally representative information will aid in projecting hematologic cancer care costs and impacts of new therapies/treatment program.