Inpatient Admissions for Infection in Cancer Patients: Impact of an Aging Population

Background: Cancer patients are particularly susceptible to infections. As cancer prevalence increases due to an aging U.S. population (a 73% increase is expected by 2025), so will the population at risk for infections.

Methods: From the 2001 Texas inpatient discharge data, we identified all cancer patients' hospitalizations which had pneumonia, bacteremia or wound infection as the admitting or principal diagnosis. We used 2003 Surveillance Epidemiology End Results (SEER) age-specific cancer prevalence estimates and 2006 and 2025 US census population projections to estimate future healthcare system burden (costs from the provider perspective and total hospital bed days utilized) due to these infections. We inflated charges to 2006 US$ using Consumer Price Index for Medical Care and derived costs using 2006 Texas Medicare cost-to-charge ratios.

Results: Over 18,000 Texas inpatients discharged in 2001 had a cancer diagnosis and a potentially preventable infection. Nationally, an estimated total of 318,164 cancer patients were hospitalized for infection in 2006 at a cost of $3.1 billion (B) (95% CI $2.8B, $3.4B) and utilizing a total of 2.3 million bed days. Assuming no change but the aging of the population, projected costs by 2025 could increase 45% to $4.5B (95% CI $4.1B, $4.9) with 27% more (3.4 million) hospital bed-days utilized.

Conclusions: Implementing measures aimed at preventing serious infections in the vulnerable cancer population may reduce healthcare system burdens as the population ages and cancer prevalence rises.