Incidence, mortality and medical costs of patients hospitalized with melanoma in Spain: a retrospective multicentre observational study

Abstract

Objective

This study aimed to update and analyze the in-hospital incidence and in-hospital mortality of melanoma in Spain, to evaluate any temporal trends in both measures and to quantify the direct medical costs of specialized care that are associated to this malignancy.

Methods

Anonymized specialized care admission records registered between 1 Jan 2011 and 31 Dec 2017 were extracted from a Spanish nationwide hospital discharge database.

Results

Records included corresponded to 16,657 patients, of which 50.62% were male. In nearly 38% of all admissions secondary malignant tumors were registered, principally tumors in the lymph nodes. In-hospital incidence of melanoma was 67.5 and 58.2 per 100,000 males and females, respectively, in the study period (2011–2017), with a decreasing tendency measured after the year 2014. Mortality increased with patients’ age and over time in patients over 75 years of age. In-hospital mortality was 7.73% for males and 5.29% for female patients, and was principally associated to metastatic tumors, principally in the lungs, liver and brain. Mean length of hospital stay was 4.36 days, with a readmission rate of 6.93% and a 15.70% of urgent admissions. The mean annual direct medical cost per patient was €4175, increasing between 2014 and 2017.

Conclusions

The increasing in-hospital incidence of melanoma appeared to reverse in 2014, as did the increasing mortality rate measured in older males. The shift in melanoma in-hospital incidence could respond to the increasing trend to treat patients in primary care settings. Further studies will be required to confirm these trends in order to adapt the healthcare system.

Keywords:

• Melanoma
• skin neoplasms
• incidence
• mortality
• Spain

Transparency

Declaration of funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Declaration of financial/other interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Author contributions

JD contributed to the investigation by analyzing and interpreting the burden associated to melanoma and other skin neoplasms in Spain and was a major contribution in the intellectual content revision. AM analyzed the current situation of melanoma and skin neoplasms in Spain, interpreted the statistical data and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.

Acknowledgements

None stated.

Data availability statement

Data sharing is restricted due to legal stipulations, yet the data that support the findings of this study is fully available from the Spanish Ministry of Health via the Unit of Health Care Information and Statistics (Spanish Institute of Health Information) for researchers who meet the criteria for access to confidential data at: https://www.mscbs.gob.es/estadEstudios/sanidadDatos/home.htm