Hispanic Ethnicity Is Associated With Increased Hospital Charges After Radical Cystectomy in the United States

Objective: To examine the impact of race and ethnicity on financial charges associated with radical cystectomy (RC). Methods: The Nationwide Inpatient Sample was used to identify patients who underwent RC between January 1 1998 and December 31 2010. The primary outcome was hospital charges adjusted for inflation. Multivariable analysis was performed using a fully-adjusted generalized linear model on the logarithmically transformed outcome variable (total hospital charges). Results: Hispanic and black patients were more likely to be treated by low-volume surgeons and/or institutions (P<.001) and to be uninsured (P0.001). After adjustment for inflation, the median charge for RC overall was $64,480 and was higher for Black patients ($71,671) and Hispanic patients ($87,485) than for White patients ($63,307) (P<.001). By multivariable analysis, Hispanic ethnicity was independently associated with higher charges (exponentiated coefficient, 1.21; 95% CI, 1.15-1.28) (P<.001), whereas black race was not (exponentiated coefficient, 1.04; 95% CI, 0.99-1.08) (P=.07). Conclusions: Hispanic ethnicity independently predicted higher hospital charges after RC.