Analysis of the Spectrum and Characteristics of Pediatric Cancer Based on Hospital Information Systems in China

Abstract

Purpose

The purpose of this study was to use the hospital information system to analyze the cancer profile and compare demographics, hospitalization, status of surgery and treatment cost of various cancer categories based on the electronic health record (EHR) of outpatient children with tumors in Shanghai, China.

Patients and Methods

Information was collected from 3834 inpatients aged 0–18 who were diagnosed with malignant tumors in all 17 hospitals with pediatric wards in the Pudong New District of Shanghai from 2011 to 2016. All patients were classified according to the International Classification of Childhood Cancer-3 (ICCC-3). The chi-squared test was used to compare demographics, hospitalization information, status of surgery and treatment cost according to inpatients’ cancer category.

Results

In both the malignant non-solid tumor and solid tumor groups, males and those aged 0–4 years were the dominant groups. Lymphocytic leukemia was the most common cancer in all inpatients (n=994, 25.93%), and the acute myeloid leukemia had the longest length of stay of inpatients (median=26.00 days). In both the non-solid and solid tumor groups, patients who received only one type of surgery had an advantage. The highest proportion of patients who had undergone surgery was found in non-Hodgkin lymphoma patients. In terms of total cost, surgical cost and medicine cost, the expenditure of central nervous system tumor patients was the highest. Astrocytoma had the highest total cost.

Conclusion

Leukemia is common in children with cancer in Pudong and should be given attention. Because the highest financial burden falls on patients with central nervous system tumors and acute myeloid leukemias, the government should take immediate and targeted measures for these cancers in particular.

Keywords:

• malignant tumors
• disease burden
• demographics
• hospitalization information
• epidemiology

Acknowledgment

We sincerely acknowledge and appreciate the assistance of the Information Center of the Health and Family Planning Commission of the Pudong New District in Shanghai for their help in collecting the data. Huining Zhou and Zhengyi Wu are co-first authors of this paper.

Abbreviations

ICCC, International Childhood Cancer Classification; EHR, electronic health record; ICD, International Classification of Diseases; ICD-O, International Classification of Diseases for Oncology.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval

We acquired written informed consent from the study participants. This study was approved by the Ethics Committees of Tongji University (ref: LL-2016-ZRKX-017). Participants’ personal information like ID and name was not available to the analysts in the research.

Disclosure

The authors report no conflicts of interest in this work.