Abstract
Introduction: Colon cancer is a common and deadly inpatient diagnosis in internal medicine and gastroenterology. It is an aggressive malignancy which is associated with a high mortality rate and a poor prognosis. The aim of this study was to use a national database of U.S. hospitals to evaluate the incidence and costs of hospital admission associated with colon cancer. Methods: We analyzed the National Inpatient Sample Database (NIS) for all patients in which malignant neoplasm of the colon (ICD-9 code: 153) was the principal discharge diagnosis from 1997-2012. The NIS is the largest all-payer inpatient database in the United States containing data from approximately 8 million hospital stays each year. The statistical significance of the difference in the number of hospital discharges, length of stay and associated hospital costs over the study period was determined by using the Chi-square test for trends. Results: In 1997, there were 108,769 admissions with a principal discharge diagnosis of colon cancer as compared to 90,460 in 2012 (GoF test, p < 0.001, Figure 1). The mean length of stay for colon cancer decreased by 18 % between 1997 and 2012 from 9.6 days to 7.9 days (p < 0.001). However, during this period the mean hospital charges increased by 186.5 % from $24307 per patient in 1997 to $69648 per patient in 2012 (p < 0.001, Figure 2). The in-hospital mortality rate also decreased quite significantly from 5.48% in 1997 to 3.46% in 2012 (p < 0.001).Figure 1Figure 2Conclusion: The number of inpatient discharges related to colon cancer have gradually decreased over the last 16 years in the United States. However, there has been a great increase in the charges and a great decline in the inpatient mortality. Inpatient costs associated with colon cancer contribute significantly to the total healthcare bill. Further research on cost-effective evaluation and management of colon cancer is required.
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