title: Incidence trends and predictors for cost and average lengths of stay in colorectal cancer surgery.
abstract: OBJECTIVE
  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 778 patients 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 and 95% 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 of 64.53 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 was 12.21 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.
  
  
  CONCLUSIONS
  These results can be generalized to patient populations elsewhere in Taiwan and to other countries with similar patient profiles.
authors.affiliation: Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Department of Medicine, E-Da Hospital, Kaohsiung City 824, Taiwan.
authors.forename: Daw-Shyong
authors.initials: DS
authors.lastname: Perng
authors.affiliation: Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Department of Medicine, E-Da Hospital, Kaohsiung City 824, Taiwan.
authors.forename: I-Cheng
authors.initials: IC
authors.lastname: Lu
authors.affiliation: Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Department of Medicine, E-Da Hospital, Kaohsiung City 824, Taiwan.
authors.forename: Hon-Yi
authors.initials: HY
authors.lastname: Shi
authors.affiliation: Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Department of Medicine, E-Da Hospital, Kaohsiung City 824, Taiwan.
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Lin
authors.affiliation: Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Department of Medicine, E-Da Hospital, Kaohsiung City 824, Taiwan.
authors.forename: Kuang-Wen
authors.initials: KW
authors.lastname: Liu
authors.affiliation: Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Department of Medicine, E-Da Hospital, Kaohsiung City 824, Taiwan.
authors.forename: Ya-Fen
authors.initials: YF
authors.lastname: Su
authors.affiliation: Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Department of Medicine, E-Da Hospital, Kaohsiung City 824, Taiwan.
authors.forename: King-Teh
authors.initials: KT
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects / Q000191:economics*; D015179:Colorectal Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000191:economics*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Average hospitalization cost; Average lengths of stay; Colorectal cancer; Colorectal cancer surgery; Incidence trend