Abstract: Racial and Socioeconomic Disparities in Inpatient Outcomes Among Older Adults Hospitalized With Prostate Cancer: Insights from the National Inpatient Sample (2020-2022).
Prostate cancer is the most common malignancy among men in the U.S. Despite therapeutic advances, outcome disparities driven by racial and socioeconomic factors persist. This study uses the National Inpatient Sample (NIS) to evaluate inpatient outcomes by race and socioeconomic status among older adults hospitalized with prostate cancer.
We conducted a retrospective analysis using the NIS (2020-2022), identifying men aged ≥65 years with a prostate cancer using ICD-10 codes. Primary outcomes included in-hospital mortality, length of stay (LOS), discharge disposition, and total hospital charges (THC). Race was categorized as White (reference), Black, Hispanic, and Other. Multivariate regression analyses adjusted for demographic, clinical, and hospital-level factors.
An estimated 437,810 hospitalizations were identified. White patients comprised 69.2%, followed by Black (16.3%), Hispanic (7.2%), and Other (7.4%). Most had a high comorbidity burden (Charlson index ≥3 in 85.1%). Black patients were younger, with a higher proportion aged 65-74 years (71.0% vs. 59.2%) and were more often from the lowest income quartile (46.3% vs. 28.1%) compared with White. Medicare was the predominant payer (87.9%), and 75.1% of admissions occurred at urban teaching hospitals. Nearly half were discharged home (44.6%), 50.1% to facilities or home health, and 5.3% died in-hospital. After adjustment, Black (OR 1.24), Hispanic (OR 1.19), and Other (OR 1.17) patients had higher odds of inpatient mortality. LOS was longer for Black (+1.17 days) and Other (+0.47 days). Black patients had higher odds of non-home discharge (OR 1.31), and THC were higher for Black (+$3,394), Hispanic (+$15,985), and Other (+$10,934) patients compared with White (all p < 0.05).
Racial and socioeconomic disparities persist in prostate cancer hospitalizations. Disparities were seen as they related to number of hospitalizations, inpatient mortality, income, LOS, odds of non-home discharge, and THC. Thoroughly addressing these disparities will promote better outcomes for all patients.
We conducted a retrospective analysis using the NIS (2020-2022), identifying men aged ≥65 years with a prostate cancer using ICD-10 codes. Primary outcomes included in-hospital mortality, length of stay (LOS), discharge disposition, and total hospital charges (THC). Race was categorized as White (reference), Black, Hispanic, and Other. Multivariate regression analyses adjusted for demographic, clinical, and hospital-level factors.
An estimated 437,810 hospitalizations were identified. White patients comprised 69.2%, followed by Black (16.3%), Hispanic (7.2%), and Other (7.4%). Most had a high comorbidity burden (Charlson index ≥3 in 85.1%). Black patients were younger, with a higher proportion aged 65-74 years (71.0% vs. 59.2%) and were more often from the lowest income quartile (46.3% vs. 28.1%) compared with White. Medicare was the predominant payer (87.9%), and 75.1% of admissions occurred at urban teaching hospitals. Nearly half were discharged home (44.6%), 50.1% to facilities or home health, and 5.3% died in-hospital. After adjustment, Black (OR 1.24), Hispanic (OR 1.19), and Other (OR 1.17) patients had higher odds of inpatient mortality. LOS was longer for Black (+1.17 days) and Other (+0.47 days). Black patients had higher odds of non-home discharge (OR 1.31), and THC were higher for Black (+$3,394), Hispanic (+$15,985), and Other (+$10,934) patients compared with White (all p < 0.05).
Racial and socioeconomic disparities persist in prostate cancer hospitalizations. Disparities were seen as they related to number of hospitalizations, inpatient mortality, income, LOS, odds of non-home discharge, and THC. Thoroughly addressing these disparities will promote better outcomes for all patients.
Authors
Tahir Tahir, Anwar Anwar, Waheed Waheed, Farooqi Farooqi, Roberts Roberts, Khan Khan
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