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theses

The overall goal of the project was to identify the factors and costs associated with Colon Cancer patients in terms of mortality, length of stay and costs in different types of clinical settings across the United States. Accordingly this research study utitlized the datasets for 2008 to 2010 available from the Nationwide Inpatient Sample (NIS) database with hospitalization characteristics of patients admitted with Colon Cancer as the principal diagnosis. Some of the important results found in this study were: Between 2008 and 2010 the age and population adjusted incidences and the hospital discharges both decreased significantly which is a promising trend speaking well of the state of health care in the United States as also possibly due to the effectiveness of nutritional counseling, patient education, screening for men aged 50 and above. It was found that while the total number of colon cancer patient discharges decreased significantly between 2008 to 2010, the Total Charges however significantly risen up between 2008 and 2010. The mean charges increased by nearly 8 %. The number of discharges across the various hospital types and their locations across the United States as shown above revealed that those large hospitals in metropolitan regions and those that are private not-for-profit have more discharges compared to the other types. Patients who are uninsured and those on Medicaid (low income) are more in number over the years 2008 to 2010 as compared to those on Medicare and Private Insurance which have decreasing trends. It was found that the mean and median length of stay of colon cancer patient discharges remained more or less the same between 2008 and 2010. It was found that the number of in-hospital mortality or deaths significantly reduced between 2008 and 2010. Alongside Home Health Care increased while discharges to another hospital also decreased (with a smaller decrease in discharge to another institution such as rehab facility and nursing home). The number of in-hospital deaths has a decreasing trend in the number of deaths over the years 2008 to 2010. Southern United States has more (nearly 2 times) in-hospital deaths compared to the other regions in all the 3 years. This study seems to indicate that mortality is positively correlated with the total costs and this may be due to a significant admission source is from emergency department. The in-hospital mortality prediction model above revealed significant risk for patients with hypertension (nearly 100%) and with obesity (62 % more) Patients with white ethnicity have lower risk of dying in the hospital compared to the other ethnicities which all have similar odds ratio intervals. This research study was limited to the datasets available from the Nationwide Inpatient Sample (NIS) database with hospitalization characteristics of patients admitted with Colon Cancer as the principal diagnosis. A similar large scale dataset based future study is indeed warranted to analyze demographic and hospital based outcomes for a wider variety of Colon Cancer patients admitted for screening, cancer management, clinical trials and education.

ETD_6011

Ph.D.

Includes bibliographical references

by Abdullah Alqahtani

doi:10.7282/T3TH8PDD

ETD doctoral

The author owns the copyright to this work.