Determinants of hospital length of stay for cervical dysplasia and cervical cancer: does managed care matter?

Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.

OBJECTIVE: To examine whether type of health insurance plan, among other variables, affects the length of stay for cervical cancer-related hospitalizations. STUDY DESIGN, PATIENTS, AND METHODS: Inpatient admission claims records for cervical dysplasia and cervical cancer were selected for 1994-1997 from the MarketScan private health insurance claims database. After identifying records by stage of disease and deleting records for pregnant women, 1145 unique patient records were used in a truncated count regression model to analyze the predictors of hospital length of stay. RESULTS: All later stages of disease were associated with a longer hospital stay. After controlling for other variables, the coefficients showed an increase in predicted length of admission ranging from 2.5 days for stage I to 6.3 days for stage IV cervical cancer compared with dysplasia/carcinoma in situ (all stages, P < .01). There was no significant statistical difference in the lengths of stay for patients covered under comprehensive fee-for-service plans vs other types of health insurance plans, including managed care. CONCLUSIONS: Managed care plans are often thought to contain healthcare costs by shortening the hospital length of stay. Our findings show no association between managed care plans and hospital length of stay for women with cervical cancer or its precursors.

PMID: 14738185 [PubMed - indexed for MEDLINE]