Incidence trends and predictors for cost and average lengths of stay in colorectal cancer surgery

• Published in: World journal of gastroenterology : WJG 2014-01, Vol.20 (2), p.532-538
• Main Authors: Perng, Daw-Shyong, Lu, I-Cheng, Shi, Hon-Yi, Lin, Chih-Wen, Liu, Kuang-Wen, Su, Ya-Fen, Lee, King-Teh
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Ave; Average; Brief; cancer; Colectomy - adverse effects; Colectomy - economics; Colorectal; Colorectal Neoplasms - economics; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; cost; Cost Savings; Cost-Benefit Analysis; Female; Hospital Costs; hospitalization; Humans; Incidence; Length of Stay - economics; Logistic Models; Male; Middle Aged; Odds Ratio; Outcome and Process Assessment (Health Care) - economics; Retrospective Studies; Taiwan - epidemiology; Time Factors; Treatment Outcome
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v20.i2.532

AIM:To evaluate the changing trends and outcomes of colorectal cancer(CRC)surgery performed at a large single institution in Taiwan.METHODS:This study retrospectively analyzed 778patients who received colorectal cancer surgery at E-Da Hospital in Taiwan from 2004 to 2009.These patients were from health examination,inpatient or emergency settings.The following attributes were analyzed in patients who had undergone CRC surgical procedures:gender,age,source,surgical type,tumor number,tumor size,number of lymph node metastasis,pathologic differentiation,chemotherapy,distant metastases,tumor site,tumor stage,average hospitalization cost and average lengths of stay(ALOS).The odds ratio and95%confidence intervals were calculated to assess the relative rate of change.Regression models were employed to predict average hospitalization cost and ALOS.RESULTS:The study sample included 458(58.87%)males and 320(41.13%)females with a mean age of64.53 years(standard deviation,12.33 years;range,28-86 years).The principal patient source came from inpatient and emergency room(96.02%).The principal tumor sites were noted at the sigmoid colon(35.73%)and rectum(30.46%).Most patients exhibited a tumor stage of 2(37.28%)or 3(34.19%).The number of new CRC surgeries performed per 100000 persons was12.21 in 2004 and gradually increased to 17.89 in 2009,representing a change of 46.52%.During the same period,the average hospitalization cost and ALOS decreased from$5303 to$4062 and from 19.7 to 14.4 d,respectively.The following factors were associated with considerably decreased hospital resource utilization:age,source,surgical type,tumor size,tumor site,and tumor stage.CONCLUSION:These results can be generalized to patient populations elsewhere in Taiwan and to other countries with similar patient profiles.