PA Health Care Cost September 2019 Containment Council Cancer Hospitalizations for Pennsylvania Children This research brief examines hospitalizations for Pennsylvania children (under age 18) who were admitted to a Pennsylvania general acute care Research hospital with a cancer diagnosis. It includes data from calendar years 2016, 2017 and 2018. The analysis does not include Briefs Pennsylvania children admitted to a hospital outside Pennsylvania for cancer treatment. There were 8,827 hospital admissions with a cancer Outpatient Services diagnosis among Pennsylvania children during the three- During the three-year period 2016- year period 2016-2018. 2018, there were 19,121 outpatient records (non-physician office) for 3,035 2,840 2,952 children where cancer was the primary reason for the visit, accounting for 3.4% of all outpatient records for children. The most common outpatient services for these 2016 2017 2018 children were:  Chemotherapy (54.1%).  Blood transfusion (7.6%). On average, there were 8 hospital admissions per day for  Diagnostic and biopsy children with a cancer diagnosis during the three-year procedures (6.3%). period. Types of Childhood Cancer Admissions 2.5% 2.7% Leukemias 3.3% 31.7% Other and Unspecified Secondary (Metastatic) 5.6% Bone, Connective Tissue and Skin 10.2% Brain and Nervous System 17.4% Non-Hodgkin's Lymphoma Hodgkin's Disease 10.7% 16.0% Digestive System Kidney and Urinary Tract Note: This analysis includes cases where cancer was the principal reason for the admission and cases where the patient was admitted for another reason but also had a diagnosis of cancer. Pennsylvania Health Care Cost Containment Council 1 Cancer Admissions, By Age Cancer Admissions, By Payer 15-17 years 17.4% Commercial <5 years 49.5% 36.9% 10-14 years 21.7% Other Medicaid 5-9 years 1.5% 45.1% 24.0% Uninsured 3.9% Age Breakdown by Cancer Type Leukemias Secondary (Metastatic) Bone, Connective Tissue and Skin (2,794 cases) (1,409 cases) (947 cases) Age Percent of Cases Age Percent of Cases Age Percent of Cases <5 ........................... 37.1% <5 .......................... 41.7% <5 ........................... 15.7% 5-9.......................... 28.9% 5-9 ......................... 24.7% 5-9 .......................... 18.4% 10-14...................... 21.0% 10-14 ..................... 17.8% 10-14 ...................... 32.1% 15-17...................... 13.0% 15-17 ..................... 15.8% 15-17 ...................... 33.8% Brain and Nervous System Non-Hodgkin’s Lymphoma Hodgkin’s Disease (896 cases) (497 cases) (287 cases) Age Percent of Cases Age Percent of Cases Age Percent of Cases <5 ........................... 34.9% <5 ............................ 9.3% <5 ............................. 3.1% 5-9.......................... 32.3% 5-9 ......................... 24.9% 5-9 ............................ 1.4% 10-14...................... 21.3% 10-14 ..................... 40.6% 10-14 ...................... 38.7% 15-17...................... 11.5% 15-17 ..................... 25.2% 15-17 ...................... 56.8% Digestive System Kidney and Urinary Tract Other and Unspecified (236 cases) (225 cases) (1,536 cases) Age Percent of Cases Age Percent of Cases Age Percent of Cases <5 ........................... 55.5% <5 .......................... 81.8% <5 ........................... 52.2% 5-9.......................... 14.0% 5-9 ......................... 13.3% 5-9 .......................... 20.0% 10-14...................... 15.7% 10-14 ....................... 4.0% 10-14 ...................... 14.7% 15-17...................... 14.8% 15-17 ....................... 0.9% 15-17 ...................... 13.1% Pennsylvania Health Care Cost Containment Council 2 Childhood Cancer Hospitalization Rate per 10,000 County Residents Under Age 18 Three-Year Period 2016 through 2018 Statewide Rate: 33.1 Erie 27.9 Warren McKean Susquehanna 31.9 Tioga Bradford 37.7 Crawford 20.8 Potter 47.7 51.2 37.2 39.1 Wayne Forest 19.1 Wyoming NR Sullivan 49.7 Venango Elk Cameron 57.8 22.5 NR Lackawanna Mercer NR 29.8 Pike Lycoming 11.1 17.0 Clinton 58.5 Clarion 36.5 39.9 Jefferson Luzerne 33.0 Columbia 33.4 Monroe Lawrence Montour 26.0 30.3 Clearfield Union NR 51.5 Butler 49.7 Centre 27.2 Carbon 16.0 Armstrong 15.9 12.3 46.9 Northumberland Beaver Snyder Northampton 29.6 23.5 14.9 Schuylkill 43.0 Indiana 31.6 Lehigh 13.2 37.6 Mifflin Juniata Allegheny Cambria Blair 51.6 34.4 57.5 38.1 39.0 Perry Berks 71.0 Dauphin Lebanon 40.5 Bucks Westmoreland 21.3 39.1 Huntingdon 32.4 Washington 37.8 28.8 Montgomery 47.8 Cumberland 36.8 35.7 Lancaster Somerset Bedford 27.4 49.8 Chester Fayette 59.1 Fulton Franklin 19.5 Delaware Philadelphia Greene 35.3 NR 22.3 Adams York 34.4 76.0 19.2 35.1 24.6 Hospitalization Rate per 10,000 NR: Not reported due to low volume. 11.1 27.3 43.5 59.8 76.0 Note that county rates were not adjusted for population differences (e.g., age and sex) so that important effects of these patient characteristics were not masked by such adjustment. Rates included residents under age 18 and were calculated using PHC4 hospital discharge data and US Census Bureau data (2018 population figures). About PHC4 Created by the Pennsylvania General Assembly in 1986, the Pennsylvania Health Care Cost Containment Council (PHC4) is an independent state agency charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care in the state. Today, PHC4 is a recognized national leader in public health care reporting. PHC4 is governed by a 25-member board of directors, representing business, labor, consumers, health care providers, insurers and state government. Joe Martin, Executive Director 225 Market Street, Suite 400, Harrisburg, PA 17101 717-232-6787 www.phc4.org Pennsylvania Health Care Cost Containment Council 3 Childhood Cancer Hospitalizations per 10,000 County Residents Under Age 18 Three-Year Period 2016 through 2018 2016-2018 Hospitalizations 2016-2018 Hospitalizations Number Rate Number Rate Statewide 8,827 33.1 Juniata 28 51.6 Adams 40 19.2 Lackawanna 130 29.8 Allegheny 796 34.4 Lancaster 351 27.4 Armstrong 58 46.9 Lawrence 88 51.5 Beaver 94 29.6 Lebanon 125 39.1 Bedford 46 49.8 Lehigh 313 37.6 Berks 383 40.5 Luzerne 210 33.4 Blair 98 39.0 Lycoming 138 58.5 Bradford 63 47.7 McKean 17 20.8 Bucks 410 32.4 Mercer 37 17.0 Butler 61 16.0 Mifflin 58 57.5 Cambria 98 38.1 Monroe 103 30.3 Cameron NR NR Montgomery 652 36.8 Carbon 15 12.3 Montour NR NR Centre 47 15.9 Northampton 267 43.0 Chester 231 19.5 Northumberland 26 14.9 Clarion 31 39.9 Perry 69 71.0 Clearfield 71 49.7 Philadelphia 1,206 34.4 Clinton 30 36.5 Pike 11 11.1 Columbia 33 26.0 Potter 13 39.1 Crawford 66 37.2 Schuylkill 87 31.6 Cumberland 186 35.7 Snyder 21 23.5 Dauphin 131 21.3 Somerset 77 59.1 Delaware 441 35.1 Sullivan NR NR Elk 13 22.5 Susquehanna 28 37.7 Erie 165 27.9 Tioga 42 51.2 Fayette 87 35.3 Union 24 27.2 Forest NR NR Venango 57 57.8 Franklin 76 22.3 Warren 24 31.9 Fulton NR NR Washington 194 47.8 Greene 55 76.0 Wayne 16 19.1 Huntingdon 24 28.8 Westmoreland 241 37.8 Indiana 22 13.2 Wyoming 26 49.7 Jefferson 30 33.0 York 242 24.6 NR: Not reported due to low volume. Pennsylvania Health Care Cost Containment Council 4