Rising costs and hospital admissions for hepatocellular carcinoma in Portugal (1993-2005)

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AIM: To determine, for hepatocellular carcinoma (HCC), the patient demographic profile and costs of their admissions to the hospitals of the Portuguese National Health System from 1993 to 2005.METHODS: The National Registry (ICD-9CM, International Classification of Diseases, 155.0) provided data from the 97 Hospitals in Portugal.RESULTS: We studied 7932 admissions that progressively rose from 292 in 1993 to 834 in 2005, having a male predominance of 78% (6130/7932). The global rate of hospital admissions for HCC rose from 3.1/105 in 1993 to 8.3/105 in 2005. The average length of stay decreased from 17.5 ± 17.9 d in 1993 to 9.3 ± 10.4 d in 2005, P < 0.001. The average hospital mortality for HCC remained high over these years, 22.3% in 1993 and 26.7% in 2005. Nationally, hospital costs (in Euros - ∈) rose in all variables studied: overall costs from ∈533000 in 1993, to ∈4629000 in 2005, cost per day of stay from ∈105 in 1993, to ∈597 in 2005, average cost of each admission from ∈1828 in 1993, to ∈5550 in 2005. In 2005, 1.8% (15/834) of hospital admissions for HCC were related to liver transplant, and responsible for a cost of about ∈1.5 million, corresponding to one third of the overall costs for HCC admissions in that same year.CONCLUSION: From 1993 to 2005 hospital admissions in Portugal for HCC tripled. Overall costs for these admissions increased 9 times, with all variables related to cost analysis rising accordingly. Liver transplant, indicated in a small group of patients, showed a disproportionate increase in costs.
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