Breaking down cancer costs: Hospital charges for patients with melanoma.

Abstract

e18921 Background: 78,000 new melanoma cases are diagnosed every year in the US and many present to the emergency department (ED). Furthermore, the increasing cost of healthcare has been well established. However, there is little data on the annual trends of hospital charges and risk factors for a high charge for these patients. Methods: We utilized the 2006-2012 Nationwide Emergency Department Sample to analyze the charges of melanoma patients. Multivariate linear regressions were used to identify factors associated with higher ED and inpatient (IP) costs. The 20 most common primary diagnoses of these patients were included in the analysis to consider the reason to visit the ED. Charges were corrected for inflation by normalizing to the 2012 US Dollar. Results: Between 2006 and 2012, 239,956 melanoma patients presented to the ED. In this time period, melanoma patients were charged a total of $567,834,100 (95% Confidence Interval (CI): $519,399,100 - $616,269,100) in the ED. The average per-patient ED charge was $3,284 (95% CI: $3,152-$3,416). The per-patient ED charge increased from $2,309 (95% CI:$2,144-$2,476) in 2006 to $3,844 (95% CI:$3,638-$4,049) in 2012 (p < 0.001), even after correcting for inflation. In the IP setting (57.6% of melanoma patients were admitted), melanoma patients were charged a total of $5,151,730,000 (95% CI:$4,768,685,000-$5,534,776,000). The average per-patient IP charge during this time period was $38,304 (95% CI: $36,952-$39,656). Over time, the per-patient IP charge increased from $34,591 (95% CI: $32,606-$36,576) in 2006 to $41,245 (95% CI:$39,151-$43,448) in 2012 (p < 0.001), even after correcting for inflation. Table 1 shows the top 5 factors associated with higher ED and IP charges. Conclusions: The ED and IP charges associated with melanoma patients has steadily increased during this period, even after correcting for inflation. ED per-patient charges have increased by a factor of 1.7 and IP per-patient charges have increased by a factor of 1.2. Furthermore, patients that present to hospitals in the West or to a Trauma Level I center have significantly higher charges. [Table: see text]