Inpatient management of patients with skin cancer in Germany: an analysis of the nationwide DRG-statistic 2005-2006

Abstract

In 2004, Germany introduced a nationwide DRG (Diagnosis Related Groups) based recompensation system for hospitals. The aim of this study was to provide nationwide quantitative information about the in-hospital management of skin cancer patients in Germany based on the DRG statistic of the years 2005 through 2006. We analysed the DRG statistic of the years 2005 and 2006. For each hospitalisation, diagnoses and procedures codes were analysed. The unit of analysis was the hospital admission with a diagnosis of skin melanoma (MEL) or nonmelanoma skin cancer (NMSC) including 151.144 hospitalisations. In 60% and 28% of all MEL- and NMSC-related hospitalisations respectively, skin cancers were surgically excised. Local therapies other than surgical excision were more prevalent among hospitalisations for NMSC than for MEL (9% vs. 4%). 22% and 1% of all MEL-related and NMSC-related hospitalisations respectively included a systemic chemotherapy. Plastic surgery was more common among NMSC-related hospitalisations (56%) than among MEL-related hospitalisations (30%). Native CT or MRI scans were coded in 11% and 2% of all MEL- and NMSC-related hospitalisations respectively. Age-standardized hospitalisation rates for MEL and NMSC varied considerably across the 16 Federal States of Germany. However, these rates were neither associated with the number of dermatology hospital beds or number of registered dermatologists. We provide for the first time nationwide quantitative data on the in-hospital management of skin cancer patients. The observed differences in the management of MEL and NMSC most likely reflect differences of the biology, epidemiology and therapeutic modalities of these cancers.