Agency News and Notes

Fewer women are having inpatient breast cancer surgery

Hospital admissions for breast cancer fell by a third between 1997 and 2004, according to a new report by the Agency for Healthcare Research and Quality (AHRQ). The decline reflects, in part, the shift to outpatient facilities for breast cancer surgeries, plus the growing use of breast-conserving operations such as lumpectomies, which are typically performed on an outpatient basis.

The hospitalization rate for women with breast cancer dropped from 90 per 100,000 women to slightly fewer than 61 per 100,000 women during the period, and the number of hospital stays for the disease declined from about 125,000 to 90,000. The study also found that:

• In 2004, mastectomies—the removal of the entire breast and some of the lymph nodes under the arm—accounted for 70 percent of breast cancer surgeries in the hospital. Lumpectomies, which remove the malignant tumor and some surrounding tissue, comprised 14 percent.
• Between 1997 and 2004, inpatient mastectomy rates decreased by 32 percent and lumpectomy rates fell by 45 percent.
• Breast cancer hospitalizations occurred the most in Massachusetts, New York, Pennsylvania, and other northeastern States (76 per 100,000 women), and the least in Arizona, California, Hawaii, and other western States (54 per 100,000 women).
• The average cost for a breast cancer patient stay—what it cost hospitals to treat the patients—was $6,500, and nearly 85 percent of all hospital stays were billed to private insurance and Medicare.

These statistics are from the Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type as well as the uninsured. For more data, go to Hospital Stays for Breast Cancer, 2004: HCUP Statistical Brief #15, at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb15.pdf.

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