Hawaiʻi 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. To describe community and individual factors associated with Hawaiʻi’s melanoma inpatients between 2016 and 2023. 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). 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 The prevalence of melanoma in Hawaiʻi 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. Hospitalization for melanoma in Hawaiʻi was associated with male sex, age, and resident area. NH-PI, and those having a greater number of secondary diagnoses had longer LOS. • This article reveals differences and similarities between Hawaiʻi inpatients and the existing national and global literature on melanoma. • Dermatologists should be aware of the potential for these differences within their own distinct communities and work toward reducing disparities for melanoma inpatients. • Male sex and age ≥ 80 were associated with higher odds of head and neck melanoma in Hawaiʻi. • Maui residents had increased odds of head and neck melanoma compared to those in Honolulu. • Native Hawaiian-Pacific Islander patients had a length of stay 2.7 times that of White patients. • A greater number of comorbidities was associated with a longer hospital stay. • Inpatient data reveal demographic and geographic melanoma disparities in Hawai‘i.
Zimmerman et al. (Fri,) studied this question.