An increasing number of oral cancer hospitalizations are discharged to long term facilities in the United States

Objectives: Over the past few decades healthcare facilities have implemented several measures to control the burgeoning healthcare expenditures in the United States. We hypothesized that over a nine year period (years 2000 through 2008), an increasing proportion of patients are discharged to long term facilities as opposed to routine discharge following hospitalization for oral and oropharyngeal cancers in the United States.

Methods: The Nationwide Inpatient Sample of Healthcare Cost and Utilization Project for years 2000-2008 was used. ICD-9-CM diagnoses codes for oral and oropharyngeal cancers were used to select case for analysis. Primary outcome variable of interest was discharge to home health care (HHC) or skilled nursing facilities (SNF) as opposed to routine discharge. The main indepdent variable of interest was the year of discharge. All statistical tests were two-sided. A p-value less than 0.05 was deemed statistically significant.

Results: During the study period, hospitalizations in years 2004 through 2008 were associated with an increased odds for being discharged to HHC/SNF as opposed to rountine discharge when compared to those in the year 2000 (odds ratio ranged from 1.24 to 1.41 for each year, p<0.05). Hospitalizations covered by Medicare and Medicaid were associated with higher odds of discharge to HHC/SNF compared to those covered by private insurance (p<0.0001). Presence of comorbid conditions increased the odds of discharge to HHC/SNF (p<0.0001).

Conclusions: During the later years of the study period, a significantly greater proportions of hospitalizations were discharged to HHC/SNF rather than routine discharge.