Brief Article
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World J Gastroenterol. Jan 14, 2014; 20(2): 532-538
Published online Jan 14, 2014. doi: 10.3748/wjg.v20.i2.532
Incidence trends and predictors for cost and average lengths of stay in colorectal cancer surgery
Daw-Shyong Perng, I-Cheng Lu, Hon-Yi Shi, Chih-Wen Lin, Kuang-Wen Liu, Ya-Fen Su, King-Teh Lee
Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Department of Medicine, E-Da Hospital, Kaohsiung City 824, Taiwan
Daw-Shyong Perng, I-Cheng Lu, Chih-Wen Lin, Kuang-Wen Liu, I-Show University, Kaohsiung City 840, Taiwan
Hon-Yi Shi, Chih-Wen Lin, Ya-Fen Su, King-Teh Lee, Graduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
Kuang-Wen Liu, Division of Colorectal Surgery, Department of Surgery, E-Da Hospital, Kaohsiung City 824, Taiwan
Author contributions: Perng DS and Lee KT designed research; Su YF and Liu KW performed research; Lu IC and Lin CW contributed new reagents or analytic tools; Shi HY analyzed data; Perng DS wrote the paper.
Correspondence to: Dr. King-Teh Lee, MD, Graduate Institute of Healthcare Administration, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan. hshi@kmu.edu.tw
Telephone: +886-7-3211101 Fax: +886-7-3137487
Received: August 10, 2013
Revised: September 30, 2013
Accepted: October 17, 2013
Published online: January 14, 2014
Processing time: 162 Days and 3.9 Hours
Abstract

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 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.

CONCLUSION: These results can be generalized to patient populations elsewhere in Taiwan and to other countries with similar patient profiles.

Keywords: Colorectal cancer; Average hospitalization cost; Average lengths of stay; Incidence trend; Colorectal cancer surgery

Core tip: We evaluated the trend of colorectal cancer surgery and compared hospitalization cost and length of stay with those in other countries. Age, source, surgical type, tumor size, tumor site, and tumor stage were associated with decreased hospital resource utilization. To efficiently allocate of medical resources, these factors must be managed.