National trends in non-melanoma skin cancer–related hospitalizations and in-hospital outcomes in the United States, 2018–2022.

Abstract

e21552 Background: Non-melanoma skin cancers (NMSC) represent the most common malignancies in the United States and are predominantly managed in outpatient settings. However, a subset of patients require inpatient care for complex surgical management, advanced local disease, complications, or comorbidity-driven indications. Despite the high prevalence of NMSC, contemporary national data describing hospitalization burden, admission characteristics, outcomes, and resource utilization remain limited. Understanding inpatient patterns is important for contextualizing healthcare utilization and informing care delivery planning for this common malignancy. Methods: A serial cross-sectional analysis of the 2018–2022 Healthcare Cost and Utilization Project National Inpatient Sample was performed. Adult (≥18 years) hospitalizations with a principal diagnosis of non-melanoma skin cancer were included; all analyses were conducted at the hospitalization level. National estimates incorporated discharge-level survey weights with stratification and clustering to account for the complex sampling design. Outcomes included annual hospitalization volume, admission type (elective vs non-elective), in-hospital mortality, length of stay (LOS), and inflation-unadjusted hospitalization cost estimated using HCUP cost-to-charge ratios. Results: Among approximately 164.9 million weighted adult hospitalizations nationally, NMSC accounted for an estimated 22,930 weighted hospitalizations from 2018–2022 (unweighted n=4,586). Annual hospitalization volumes were stable across the study period. Overall in-hospital mortality was low at 1.40% (95% CI 1.07–1.81) without meaningful temporal variation. Most admissions were elective (68.6%; 95% CI 67.0–70.1), while 31.4% were non-elective. Mean LOS was 6.11 days (95% CI 5.85–6.37), and mean hospitalization cost was $31,104 (95% CI $29,415–$32,794). Conclusions: NMSC-related hospitalizations were uncommon relative to overall inpatient volume but were associated with prolonged LOS and substantial hospitalization costs despite low in-hospital mortality. The predominance of elective admissions and stable outcomes over time characterize contemporary inpatient NMSC care. These findings provide national benchmarks that contextualize inpatient resource utilization and inform healthcare planning for this highly prevalent malignancy.