Surgical Procedures Prevalent, Costly, for Patients with Metastatic Melanoma
The studies, conducted by Song Wang, PhD, and colleagues from Amgen, Thousand Oaks, CA, assessed the patterns of surgical procedures and estimated the costs of these procedures in patients with metastatic melanoma in the United States.
Using a large commercially insured claims database, they identified 2,399 patients from 2005 to 2011 using ICD-9-CM codes 172.xx and V10.82 for a diagnosis of melanoma and ICD-9-CM 197.xx and 198.xx for a diagnosis of metastasis. Index was the first date of diagnosis of metastasis. Surgical procedures likely related to melanoma on skin, liver, lung, soft tissue, brain, and lymph nodes were identified using CPT codes in the outpatient setting and ICD-9-CM procedures codes in the inpatient setting.
Excluded were patients with other primary malignant tumors prior to the diagnosis of melanoma and those younger than 18 years of age or not enrolled continuously for at least 6 months at the index date.
“Patients were followed from the index date to death, disenrollment, or end of the study period (31 March 2011), whichever occurred first, Dr. Wang reported. Mean age at the index was 60.2 years.
During the mean 377-day follow-up, 758 patients (31.6%) received 1,395 surgical procedures in the outpatient setting and 207 patients (8.6%) had 231 surgical procedures in the inpatient setting.
In the outpatient setting, 1,181 surgical procedures were performed on skin, 108 on soft tissue, 75 on lung, and 12 on lymph nodes. Among the 231 surgical procedures in the inpatient setting, 88 were on brain, followed by 82 on lung, 43 on lymph nodes, and 11 on liver.
The 758 patients treated in the outpatient setting received an average of 1.9 surgical procedures. Mean cost per procedure was $3,393, which varied by sites of procedure; cost was $3,096 for skin, $4,887 for soft tissue, and $2,617 for lung.
The 207 patients treated in the inpatient setting had an average of 1.1 surgical procedures. Mean length of stay (LOS) was 4.4 days and mean cost per hospitalization, $37,649. By treatment site, mean LOS was 6.4 days for brain, with a mean treatment cost of $52,511; 3.0 days for lung, with a cost of $27,545; and 2.3 days for lymph nodes, with a cost of $22,499.
Abstract (search using “ICD” as the key word).