The Impact of a Colorectal Cancer Diagnosis on Health Resource Utilization Patterns Among Patients With Hypertension Using Real-World Data

OBJECTIVES: Managing comorbidities like hypertension, exacerbated by cancer-related stress, may require extra healthcare resources for continual monitoring and management. The aim of this research was to investigate how a colorectal cancer diagnosis may impact hospitalization patterns among patients with hypertension.

METHODS: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare data (2015-2019) to identify Medicare beneficiaries aged over 66 years, enrolled in Parts A, B and D for 12 months before and following diagnosis with incident colorectal cancer (CRC). We excluded patients who developed a second cancer in the follow-up year or were missing critical descriptors. Propensity score matching was used to create a cohort of comparable CRC patients with and without hypertension. We used the proportion of patients that were hospitalized, number of annual hospitalizations per patient and average length per hospital stay to characterize hospitalization patterns. Negative binomial, log-transformed linear and binary logistic regression models were used to quantify the differences.

RESULTS: A total of 3,937 patients with pre-existing hypertension were successfully matched to patients without hypertension and were comparable in terms of demographics and clinical characteristics. Despite comparability at baseline, patients with hypertension used significantly more inpatient resources after cancer diagnosis. For example, 84.7% of patients with hypertension and 80.4% of patients without hypertension had at least one hospitalization (Odds Ratio (OR) 1.11, 95% C.I: 1.07-1.15). Similarly, the mean number of hospitalizations was 1.7 and 1.5 (Incidence Rate Ratio (IRR) 1.35, 95% C.I: 1.20-1.51) while the average length of stay was 6.4, and 6.1 (%Difference 1.04, 95% C.I: 1.00 to 1.08), for patients with hypertension versus those without hypertension, respectively.

CONCLUSIONS: These results suggest that a CRC diagnosis has a higher impact on patients with hypertension compared to those without. Quantifying the increased healthcare resource needs can assist with planning and inform further studies on resource utilization.