• Charges and Mortality Associated with Melanoma Complications in a Hospital Setting

      Skrepnek, Grant; Pangelinan, Michelle; Whitmore, Kathleen; Skrepnek, Grant; College of Pharmacy, The University of Arizona (The University of Arizona., 2013)
      Specific Aims: The purpose of this project was to determine inpatient charges, as well as define the frequency and mortality associated with the various sites of melanoma metastasis. Methods: Data was taken from the national database Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (H-CUP) Nationwide Inpatient Sample (NIS) and was collected on patients admitted into hospital with any diagnosis of melanoma with disease progression of distant metastasis. Logistic multivariate regression was used to find odds ration by patient characteristic. Overall charges were assessed using a gamma multivariant regression. Multiariant regression was used to determine other patient demographics. Main Results: Average inpatient charges for stage IV melanoma was $32,296 per patient with a national inpatient total bill of $5.56 billion. The metastatic sites associated with the highest inpatient charges were genitourinary tract (exp B = 1.276), gastrointestinal tract (exp B=1.146), bone (exp B=1.132), lung (exp B=1.097), and lymph (exp b=1.092). The most common sites of melanoma dissemination for in-patient mortality cases were lymph (21.7%), lung and respiratory (19.2%), central nervous system (17.1%), and bone (17.1%). Conclusion: The annual average hospital charges per patient for melanoma with distant metastasis is about $32,000. We suggest that metastases of the genitourinary tract, gastrointestinal tract, bone, lung, and lymphatic system are associated with the highest hospital charges, while metastases to the CNS, bone, liver, lung, GI, and wide dissemination are associated with increased mortality.