Treatment and Cost of Hepatocellular Carcinoma: A Population-Based Cohort Study in Taiwan.
Int J Environ Res Public Health
; 15(12)2018 11 26.
Article
en En
| MEDLINE
| ID: mdl-30486324
ABSTRACT
Hepatitis B virus vaccination and antiviral therapies reduce the risk of hepatocellular carcinoma (HCC). However, the lifetime healthcare expenditure involved in caring for HCC patients remains unclear. We examined the use and direct costs of healthcare services for a cohort of HCC patients to the healthcare system using Taiwan national health insurance program research database between 1997 and 2012. Total medical cost for all reimbursed patient encounters, including hospitalizations and outpatient care was cumulated from HCC onset to the end of follow-up or death. The mean follow-up time was 2.7 years (standard deviation, SD = 3.3) for the entire HCC cohort. Insurance payments of approximately US$92 million were made to 5522 HCC patients, with a mean cost of US$16,711 per patient (21,350). On average, the total cost per patient per month was US$2143 (5184); it was 50% higher for advanced cirrhosis patients at the baseline but 23% lower for mild-to-moderate cirrhotic patients. In the two-part regression, patients' underlying comorbid conditions, liver transplants, hepatectomy, and transarterial chemoembolization were associated with increased total cost, with liver transplants having the greatest impact over time. Hepatocellular carcinoma imposes substantial burden on the healthcare system. Real-world evidence on treatment and cost outcomes highlighted the needs to expand effective screening strategies and to optimize healthcare delivery to meet HCC patients' clinical needs.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Quimioembolización Terapéutica
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Carcinoma Hepatocelular
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Costos y Análisis de Costo
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Atención Ambulatoria
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Neoplasias Hepáticas
Tipo de estudio:
Etiology_studies
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Health_economic_evaluation
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Int J Environ Res Public Health
Año:
2018
Tipo del documento:
Article
País de afiliación:
Taiwán
Pais de publicación:
CH
/
SUIZA
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SUÍÇA
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SWITZERLAND