OBJECTIVES: To examine trends in hospital length of stay and total costs in lung cancer patients with brain metastases.

METHODS: The latest available 2015 National Inpatient Sample (NIS) data set of hospital admissions from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for lung cancer patients with brain metastases (identified by ICD-9 for Q1-Q3 and ICD-10 codes for Q4). The LOS and costs were compared by payer type, race and age groups.

RESULTS: Based on our inclusion criteria we found 12,720 admissions, representing 0.193% of all hospitalizations. The mean age was 66.01 years (SD: 12.44, Median 67 years).

The overall mean LOS was 5.81 days (SD: 5.76, Median 4 days). Majority of the hospitalizations were in patients age 60+ (71%), followed by age 45-60 (24%). Mean (SD) LOS by age: 0-18: 7 days (SD: 11, n= 44), 18-45: 5.8 days (SD: 6.43, n= 499), 45-59: 5.75 days (SD: 5.55, n= 3107), 60+: 5.82 days (SD: 5.74, n= 9070). The mean LOS by payer: Medicare: 5.7 days (SD: 5.42), Medicaid: 6.45 days (SD: 7.27), Private: 5.83 days (SD: 5.69).

The overall mean charges were $57,193 (SD: $71172). The mean costs by age group were 0-18: $104899 (SD: $192241), 18-45: $67638 (SD: $95980), 45-59: $58911 (SD: $70412), 60+: $55799 (SD: $68594). The mean costs by payer type were: Medicare: $55542 (SD: $68145), Medicaid: $62854 (SD: $82896), Private: $60184 (SD: $73836).

CONCLUSIONS: Lung cancer patients with brain metastases incur high costs for public and private payers due to long length of stay in the hospital. New lung cancer drug treatments which are also effective in treating brain metastases are needed.