Mapping melanoma in Hawai‘i with inpatient discharge data from 2016 to 2023: Community determinants and anatomic distribution patterns

BACKGROUND: Hawai'i has above average rates of melanoma, with head and neck melanoma (HNM) considered the most severe. Analysis of discharge records can reveal disease patterns, and demographic and geographic disparities. OBJECTIVE: To describe community and individual factors associated with Hawai'i's melanoma inpatients between 2016 and 2023. METHODS: Patients diagnosed with melanoma were identified from inpatient discharge records filed between 2016 and 2023. Multivariable logistic regression identified factors associated with HNM for inpatients. Zero-truncated negative binomial regression examined factors associated with length of stay (LOS). RESULTS: Of 409 inpatients with melanoma diagnoses, 67 had it as a principal diagnosis. HNM was less likely to be a secondary diagnosis. HNM was more commonly observed among males, age > 80, or Maui residents. Among patients with principal diagnoses, non-White patients (including Native Hawaiian and Pacific Islanders (NH-PI)) were more likely to have longer LOS than White patients, as did those with more secondary diagnoses LIMITATIONS: The prevalence of melanoma in Hawai'i cannot be inferred, given the focus on inpatient data, along with the absence of data from the self-governed health systems. Melanoma subtypes were not analyzed due to insufficient data. CONCLUSION: Hospitalization for melanoma in Hawai'i was associated with male sex, age, and resident area. NH-PI, and those having a greater number of secondary diagnoses had longer LOS.