Hospital and Medical Care Days in Pancreatic Cancer

Abstract

Background Little is known about resource utilization (number of days in the hospital or medical care) between diagnosis and death in patients with pancreatic cancer. Methods Using Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data, we identified 25,476 patients with pancreatic cancer (1992-2005). Hospital and medical care days per person-month from the time of diagnosis were described, stratified by stage, treatment, and survival duration. Results Hospital/medical care days vary by length of survival and treatment strategy in patients with pancreatic cancer. For all stages, patients were in the hospital a mean of 6.4 days and received medical care a total of 9.0 days in the first month after diagnosis, decreasing to 1.7 and 3.7 days per month, respectively, by the end of the first year. Hospital/medical care days per month of life were higher in patients with shorter survival but increased sharply at the end of life in all patients, regardless of duration of survival. In patients with locoregional disease, resection was associated with a higher number of hospital/medical care days during the first 4 months after diagnosis, but fewer at the end of the first year. For distant disease, hospital days were similar but days in medical care were higher for patients receiving chemotherapy, increasing especially at the end of life. Conclusions This study is the first to quantify hospital/medical care days in patients with pancreatic cancer by stage, treatment, and survival. This information will provide realistic expectations and allow for treatment decisions based on patient preferences.

Time Spent Away from Home in the Year Following High‐Risk Cancer Surgery in Older Adults

“…Another study in patients with pancreatic cancer looked at the number of hospital and medical care days between diagnosis and death and found that these individuals spent an average of 6.4 days in the hospital and 9.0 days receiving medical care in the first month after diagnosis, decreasing to 1.7 and 3.7 days per month in the year after diagnosis. Although this study did look at where time was spent beyond 30 days, only 9.1% of their study population underwent surgery, compared with 100% of our study cohort …”

“…Although this study did look at where time was spent beyond 30 days, only 9.1% of their study population underwent surgery, compared with 100% of our study cohort. 17 Our study is novel in its aim to document the amount of time spent away from home (ie, in a hospital and/or in a nursing home) for the entire year following high-risk cancer surgery. The proportion of days spent at home is a new and important patient-centered quality metric used in the nonsurgical literature, reflecting both intuition and academic research that suggests that individuals prefer to be at home, particularly in their final days of life.…”