Hospitalizations for infection in cancer patients: impact of an aging population.
OBJECTIVE
The aim of this study was to assess the impact of an aging US population on inpatient costs and resource utilization in cancer patients admitted for infection.


METHODS
From the Texas inpatient public use files (Texas Health Care Information Collection), which include all hospitals except federal institutions, we selected residents with cancer who also had a principal or admitting diagnosis of pneumonia, bacteremia/sepsis, or other documented infection in 2001. Selected admission records were directly adjusted by projected age-specific cancer prevalence totals for years 2006 and 2025 using surveillance epidemiology end results (SEER) and US census data. Charges were inflated to 2006 consumer price index for medical care then converted to costs using Texas Medicare cost-to-charge ratios.


RESULTS
Over 9% of nearly 200,000 Texans admitted for infection in 2001 also had cancer. Projecting these results nationally, 318,000 discharges in cancer patients at a cost of $3.1 billion (B, 95% CI $2.8B, $3.4B) and 2.3 million (M) bed days would have been attributed to infections in 2006. By the year 2025, adjusting only for the aging population, costs could increase 45% to $4.5B (95% CI $4.1B, $4.9), with 27% more (3.4 M) hospital bed days occupied.


CONCLUSIONS
Consequent to an aging population and the resulting increase in cancer prevalence, the healthcare burden of managing hospital admissions for infection in the vulnerable cancer population could be greatly magnified unless risk-based treatment and preventive strategies such as appropriate immunizations and infection control measures are implemented.
Cooksley
Catherine D
CD
Department of Biostatistics, University of Texas M. D. Anderson Cancer Center Health Services Research, PO Box 301402 Unit 1409, Houston, TX 77030, USA. ccooksle@mdanderson.org
Avritscher
Elenir B C
EB
Rolston
Kenneth V
KV
Elting
Linda S
LS
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D017281:Cost of Illness; D016208:Databases, Factual; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007239:Infections / Q000191:economics* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000191:economics; D015995:Prevalence; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult