Racial disparities in hospitalization outcomes among adult patients with prostate cancer using the National Inpatient Sample (2018-2020).

Abstract

e17007 Background: Racial disparities in prostate cancer management represent a significant health challenge with African American patients disproportionately experiencing worse outcomes. This study aims to analyze the racial disparities in hospitalization outcomes among adult patients with prostate cancer to improve clinical practice and patient outcomes. Methods: National Inpatient Sample Database (2018-2020) was analyzed for hospitalizations of patients over 18 years with primary prostate cancer. Independent variables were race, categorized as White, African American, Hispanic, and other groups. Outcomes included length of stay (LOS) categorized as more or less than 7 days, total hospital charges and patients discharge disposition categorized to routine discharge, discharge to facility/home with healthcare and death. Categorical variables were analyzed using chi-square tests. t-tests were used for continuous variables. Multivariable regression adjusted for demographics (age, gender, household income) and hospital characteristics (bed size, region, location). Results: Total of 571,445 adult hospitalizations with diagnosis of Prostate Cancer were identified with hospitalizations common among Whites (69%) than African Americans (18%), Hispanics (8%) or other racial groups (5%). The mean age is 72.5 years. Regardless of race, majority of the patients are > 70 years age and are less than (0-25th percentile) median-household-income and are from southern region followed by Midwest, northeast and western regions. Majority of patients admitted to larger hospitals with more than 50% of them undergoing routine discharge (home or self-care) and 78% had length of stay of less than 7 days. In adjusted analyses, African American patients hospitalized for Prostate Cancer had higher odds (adjusted OR 1.44, 95% CI: 1.38-1.50) of being discharged to a facility or home with health care followed by other racial groups than Whites. African American had higher odds (adjusted OR 1.55, 95% CI: 1.41-1.70) in hospital mortality followed by other racial groups when compared to Whites. There was no statistical significance of being discharged or in hospital mortality when Hispanics were compared to Whites. African Americans (adjusted OR 1.54, 95% CI: 1.47-1.60), Hispanics (adjusted OR 1.14, 95% CI: 1.07-1.20) and other racial groups (adjusted OR 1.15, 95% CI: 1.07-1.22) had higher odds of hospital-stay of 7 or more days compared to Whites. Hispanics had $11,664 higher (95% Cl: $8,765 -$14,564) total hospital charge followed by other racial groups $3,523 higher (95% Cl: $481- $6,565) followed by African Americans $2,867 higher (95% Cl: $1,172 -$ 4,561) compared to Whites. Conclusions: These findings emphasize the need for improved healthcare systems focusing on early detection, equitable treatment, and preventive care for African American patients to reduce disparities.