Abstract

Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. It’s a type of cancer that starts in cells that become certain white blood cells in the bone marrow. Aims: To analyze trends in hospital length of stay, total costs and co-morbidities in Medicare and Private Insurance patients with Chronic Lymphocytic Leukemia (CLL). Methods: The National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for Chronic Lymphocytic Leukemia. Thirty co-morbidities were assessed using Elixhauser scoring. The outcomes assessed include length of stay (LOS), total charges, co-morbidity score, mortality rate and emergency room visits. Results: There were an estimated 74,355 hospitalizations with a diagnosis of CLL, with 82% and 15% of the patients being covered by Medicare and Private Insurance, respectively. The mean age was 77.96 (SD 8.88) and 64.25 (SD 10.4) years for patients covered by Medicare and Private Insurance, respectively. The mean hospital length of stay was 5.81 (SD 6.01) and 5.91 (SD 7.18) days, for Medicare and Private Insurance patients, respectively. The mean hospital charges were $58,144 (SD $77558) and $66,721 (SD $91299) for Medicare and Private Insurance patients, respectively. The mean comorbidity score was higher for Medicare versus Private Insurance (Mean 4.22 vs 3.69, p<0.05). The in-hospital mortality rate was same 5.03% in both Medicare and Private Insurance patients. The top 5 co-morbid conditions in Medicare patients were Hypertension (45%), Cardiac Arrhythmias (39%), Fluid and Electrolyte Disorders (39%), Congestive Heart Failure (30%) and Chronic Pulmonary Disease (29%). Top 3 primary diagnoses were Sepsis, Pneumonia and Acute kidney failure. Approximately, 70% of Medicare patients were admitted to the hospital via the emergency room visit. Summary/Conclusion: Chronic Lymphocytic Leukemia patients pose significant burden on Medicare and Private Insurance with high hospital charges and long LOS. There is a need for new treatment options for CLL patients.

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