Findings from the Report on Pediatric Cancer Hospitalizations, 2009

The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of health care databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ). HCUP databases bring together the data collection efforts of State data organizations, hospital associations, private data organizations, and the Federal government to create a national information resource of patient-level health care data (HCUP Partners). HCUP includes the largest collection of longitudinal hospital care data in the United States, with all-payer, encounter-level information beginning in 1988. 

HCUP released a report today that provides various data on childhood cancer hospitalizations (aged 0-18) in 2009.  We wanted to share some of the findings (1,2):

  • In 2009 there were about 100,000 total hospital cancer-related stays for kids, about 5% of the total hospital stays for kids. 
  • Childhood cancer related hospital stays cost $1.9 billion, about 11% of all childhood hospital costs.
  • From 2000 to 2009, childhood cancer treatment costs increased 36%
  • Compared to other childhood conditions, kids with cancer stays averaged 8 days longer.
  • Compared to other childhood conditions, kids with cancer stays cost almost 5 times as much, averaging $40,000 per stay.  
  • About 55% of stays for kids with cancer were covered by private payers and only 37% were paid for by Medicaid. In contrast, nearly half of non-cancer kids stays were paid for by Medicaid.
  • The average kid with cancer was 8 years old at admission.........8.
  • The in-hospital death rate during stays principally for cancer was 3.0 percent—approximately 10 times higher than for all other pediatric hospital stays.

For comparison, a similar report Cancer Hospitalizations for Adults, 2009 finds that in 2009 stays for adults with cancer had a total cost of about $20 Billion. 

We spend $2 billion annually to treat kids with cancer and $20 billion annually to treat adults with cancer. 

Makes more NCI investment into childhood cancer research seem like a bargain; economically and ethically.

(1) The report is attached or can be viewed at: Pediatric Cancer Hospitalizations, 2009.

(2) The report differentiates between cancer-related stays that are primary and secondary.  It focus the findings on the primary.  However, secondary diagnosis is defined as follows:

"Almost half (48.2 percent) of pediatric hospital stays with a secondary diagnosis of cancer had a principal diagnosis of maintenance chemotherapy or radiotherapy (table 5). Another 15.1 percent of secondary cancer stays had a principal diagnosis of diseases of white blood cells. Approximately 5.7 percent of all stays with a secondary diagnosis of cancer had a principal diagnosis of a treatment-related complication:
complication of devices, implants or grafts (4.4 percent) or complication of surgical procedures or medical care (1.3 percent). Other common principal diagnoses included fever of unknown origin (3.4 percent of cancer-related stays) and septicemia (2.5 percent)." 

We believe we are justified in including secondary diagnosis in the overall childhood cancer evaluation, and thus have re-evaluated the data provided.  A table showing the calculations is attached. 

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