OBJECTIVES: Acute lymphocytic leukemia (ALL) is most common in children. Due to advances in therapy options, the number of long term survivors of pediatric ALL continues to increase. However, although prognosis has improved significantly over time, ALL likely continues to impose a significant economic burden on society. This study sought to assess recent trends in pediatric ALL hospitalization and aspects of related care.
METHODS: Data for pediatric (20 years) hospitalizations with a primary diagnosis of ALL (ICD-9-CM codes 204.0x) from the 1997, 2000, 2003, and 2006 HCUP Kids’ Inpatient Databases were analyzed. Weighted estimates of the number of hospitalizations for ALL and associated resource-based outcomes (i.e., total charges, length of stay [LOS], and stem cell transplant procedures) were derived.
RESULTS: Between 1997 and 2006, the rate of pediatric ALL-related hospitalizations (per 100,000 2010 US pediatric population) increased slightly then leveled off, from 6.10/100,000 in 1997 to 6.61/100,000 in 2000, 6.60/100,000 in 2003, and 6.62/100,000 in 2006. Mean LOS remained consistent until an increase in 2006 (12.1 days in 1997, 12.4 days in 2000 and 2003, to 13.6 days in 2006). Similarly, the proportion of ALL hospitalizations with evidence of stem cell transplant remained roughly unchanged at 60% until a sharp increase in 2006 to 64.9%. Finally, mean costs (2010 USD) for ALL-related stays have increased nearly 31%, from $43,247 (1997) to $56,517 (2006).
CONCLUSIONS: We examined rates of pediatric ALL-related hospitalizations and documented aspects of inpatient ALL care, and observed a slight increase in the rate of hospitalizations over time. An increase in LOS was seen in 2006, with a commensurate increase in total costs, possibly owing to a marked increase in the rate of stem cell transplant. These findings may be used to support access strategies (e.g., economic modeling efforts) for current ALL therapies, as well as for those in the developmental stage.
