Trends in Colon Cancer Colectomy Volume and Inpatient Costs, 2018-2023: A Medicare Analysis

Area of Science:

• Oncology
• Epidemiology
• Health Services Research

Background:

• Colon cancer is a leading cause of cancer in the United States.
• The COVID-19 pandemic has had long-term effects on healthcare services and patient outcomes.
• This study evaluates the impact of the pandemic on colectomy volumes and resource utilization for colon cancer patients.

Purpose of the Study:

• To assess the long-term effects of the COVID-19 pandemic on colectomy volumes for colon cancer.
• To analyze changes in resource utilization and Medicare payments post-pandemic onset.
• To understand the implications for population health and future pandemic preparedness.

Main Methods:

• A cohort study using a 5% Medicare sample from January 2018 to July 2023.
• Negative binomial models projected expected monthly colectomy volumes.
• Standardized mean differences and bootstrapping analyzed patient and procedure characteristics.

Main Results:

• Mean monthly colectomy volumes decreased from 133 pre-pandemic to 107 post-pandemic.
• Observed volumes fell below projections in April-June 2020, with no recovery by June 2023.
• Median total Medicare payments increased post-pandemic, despite similar patient characteristics.

Conclusions:

• Colon cancer colectomy volumes declined significantly due to the COVID-19 pandemic.
• An estimated 159 colectomy cases were missed, with no indication of recovery by mid-2023.
• Findings highlight the need for improved public health preparedness and inform future epidemiological estimates.