Background: Taiwan implemented a comprehensive and universal National Health Insurance (NHI) program to cover all inhabitants. This study aimed to assess the medical utilization and cost of liver cancer patients under NHI.
Methods: This retrospective cross-sectional study used a sampled NHI research database containing one million beneficiaries. Claims of liver cancer patients in 2009 were analyzed. Beneficiaries who used medical services in 2009 served as control subjects.
Results: Among 2335 liver cancer patients identified, 2178 (93.3%) patients used outpatient services and 1193 (51.1%) patients used inpatient services. Liver cancer accounted 1.8% of the total cost of NHI. The cost per visit was $59.3 for outpatient and $2070.3 for inpatient. The annual cost per patient was $4746.6, with $1951.0 for outpatient and $2795.6 for inpatient. The cost per visit and per patient of liver cancer patients were 206.0% and 666.8% of that of control subjects, respectively. Patients who were female, age at 60’s, lower income, living in Southern Taiwan, had higher cost per patient (p < 0.0001). Fees for consultation, treatment and medical supply (57.3%) accounted for the highest portion of outpatient cost, followed by drug fees (30.0%), and diagnosis fees (11.2%). Ward fees (19.0%) accounted for the highest portion of inpatient cost, followed by drug fees (18.7%), X-ray fees (14.9%). Private hospitals were visited most frequently.
Conclusions: The cost of liver cancer care is substantial and varied by sex, age, income, and geographic distribution. It is critical to identify cost-effective prevention and treatment strategies.