Baqar Husaini1, Robert Levine2, Phillip Lammers3, Pam Hull4, Meggan Novotny1, Majaz Moonis5. 1. Tennessee State University, Nashville, Tennessee 37209. 2. Baylor College of Medicine, Houston, Texas 77098. 3. Meharry Medical College, Nashville, Tennessee 37208. 4. Vanderbilt University, Nashville, Tennessee 37240. 5. University of Massachusetts, Worcester, Massachusetts 01655.
Abstract
OBJECTIVE: The role of smoking and depression relative to hospital cost for lung cancer (LC) remains unknown. METHODS: We extracted data on depression, smoking history, demographics, and hospital charges on patients with respiratory cancers (ICD-9 codes 161-163,165) from the 2008 Tennessee Hospital Discharge Data System. The sample (n=6,665) was mostly white (86%) and male (57). Age-adjusted rates were developed per CDC methodology, and hospital costs were compared for LC with vs. without depression and smoking. RESULTS: Three findings (p<.001) emerged: (i) LC rate was higher among blacks than whites, and higher among males than females; (ii) While 66% of LC smoked (more males than females without racial variation), 24% had depression (more females and whites were depressed); (iii) The LC hospital cost was 54% higher compared to non-LC, and this cost doubled for LC with depression and smoking vs. those without such characteristics. CONCLUSION: While LC is more prevalent among blacks and males, depression is higher among female and white patients. Since depression with higher costs existed among LC patients, our findings point to: (i) possibility of cost savings by diagnosing and treating depression among LC, and (ii) implementing proven smoking cessation programs to reduce LC morbidity and hospital costs.
OBJECTIVE: The role of smoking and depression relative to hospital cost for lung cancer (LC) remains unknown. METHODS: We extracted data on depression, smoking history, demographics, and hospital charges on patients with respiratory cancers (ICD-9 codes 161-163,165) from the 2008 Tennessee Hospital Discharge Data System. The sample (n=6,665) was mostly white (86%) and male (57). Age-adjusted rates were developed per CDC methodology, and hospital costs were compared for LC with vs. without depression and smoking. RESULTS: Three findings (p<.001) emerged: (i) LC rate was higher among blacks than whites, and higher among males than females; (ii) While 66% of LC smoked (more males than females without racial variation), 24% had depression (more females and whites were depressed); (iii) The LC hospital cost was 54% higher compared to non-LC, and this cost doubled for LC with depression and smoking vs. those without such characteristics. CONCLUSION: While LC is more prevalent among blacks and males, depression is higher among female and whitepatients. Since depression with higher costs existed among LC patients, our findings point to: (i) possibility of cost savings by diagnosing and treating depression among LC, and (ii) implementing proven smoking cessation programs to reduce LC morbidity and hospital costs.
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