Table 3.
Total Cost Associated with Primary Liver Cancer in US Hospitals
| Year | 2016 |
2017 |
2018 |
2019 |
r2 |
p-value |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total Cost (in million dollars) | 1,180.90 | 1,307.99 | 1,365.54 | 1,547.95 | 0.96 | 0.02 * | |||||||
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| Demographics | Total Cost (in million dollars) | (95% confidence interval) | Total Cost (in million dollars) | (95% confidence interval) | Percent Difference (%) | Total Cost (in million dollars) | (95% confidence interval) | Percent Difference (%) | Total Cost (in million dollars) | (95% confidence interval) | Percent Difference (%) | r2 for Total (in million dollars) | p-value for Total (in million dollars) |
|
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| Age | |||||||||||||
| 18 to 34 | 19.24 | (13.73 – 24.75) | 25.05 | (10.59 – 39.50) | 30.17 | 31.11 | (9.40 – 52.82) | 24.20 | 24.68 | (15.84 – 33.52) | −20.66 | 0.35 | 0.40 |
| 35 to 49 | 65.17 | (54.08 – 76.26) | 78.67 | (66.20 – 91.14) | 20.72 | 79.34 | (66.65 – 92.04) | 0.85 | 75.58 | (63.88 – 87.28) | −4.74 | 0.39 | 0.37 |
| 50 to 64 | 549.45 | (483.54 – 615.36) | 553.36 | (494.07 – 612.65) | 0.71 | 564.45 | (506.06 – 622.84) | 2.00 | 597.08 | (532.10 – 662.05) | 5.78 | 0.85 | 0.08 |
| Greater than 65 | 547.05 | (498.35 – 595.74) | 650.91 | (589.52 – 712.31) | 18.99 | 690.64 | (630.27 – 751.01) | 6.10 | 850.62 | (773.93 – 927.30) | 23.16 | 0.95 | 0.03 * |
| Gender | |||||||||||||
| Male | 813.56 | (728.29 – 898.84) | 891.50 | (806.70 – 976.30) | 9.58 | 923.90 | (834.83 – 1,012.98) | 3.63 | 1,067.21 | (969.05 – 1,165.36) | 15.51 | 0.93 | 0.04 * |
| Female | 367.34 | (329.56 – 405.11) | 416.49 | (369.16 – 463.81) | 13.38 | 441.63 | (395.24 – 488.03) | 6.04 | 480.75 | (430.29 – 531.21) | 8.86 | 0.99 | 0.007 ** |
| Race | |||||||||||||
| White | 663.34 | (595.84 – 730.83) | 727.26 | (654.06 – 800.46) | 9.64 | 769.05 | (691.47 – 846.64) | 5.75 | 879.20 | (798.49 – 959.92) | 14.32 | 0.96 | 0.02 * |
| Black | 167.28 | (146.09 – 188.48) | 177.52 | (155.14 – 199.90) | 6.12 | 176.91 | (156.55 – 197.27) | −0.34 | 181.41 | (162.68 – 200.15) | 2.55 | 0.81 | 0.10 |
| Hispanic | 200.40 | (166.44 – 234.37) | 222.21 | (190.85 – 253.57) | 10.88 | 233.25 | (200.69 – 265.81) | 4.97 | 281.34 | (233.83 – 328.85) | 20.62 | 0.92 | 0.04 * |
| Asian or Pacific Islander | 89.95 | (66.99 – 112.91) | 101.86 | (80.06 – 123.65) | 13.24 | 114.15 | (92.93 – 135.37) | 12.07 | 121.11 | (100.90 – 141.32) | 6.10 | 0.99 | 0.007 ** |
| Native American | 11.06 | (8.32 – 13.81) | 10.16 | (7.10 – 13.21) | −8.20 | 15.38 | (9.51 – 21.25) | 51.43 | 12.25 | (8.00 – 16.50) | −20.34 | 0.25 | 0.50 |
| Other | 48.87 | (36.18 – 61.56) | 68.99 | (45.93 – 92.04) | 41.16 | 56.80 | (41.40 – 72.20) | −17.67 | 72.63 | (54.96 – 90.31) | 27.88 | 0.48 | 0.30 |
| Comorbidities | |||||||||||||
|
| |||||||||||||
| Coronary Artery Disease | 11.32 | (8.29 – 14.36) | 13.80 | (10.38 – 17.22) | 21.86 | 21.84 | (16.08 – 27.61) | 58.30 | 15.86 | (12.08 – 19.65) | −27.39 | 0.39 | 0.38 |
| Congestive Heart Failure | 19.99 | (12.45 – 27.52) | 27.01 | (22.94 – 31.07) | 35.12 | 31.92 | (26.73 – 37.12) | 18.21 | 43.50 | (35.27 – 51.73) | 36.27 | 0.97 | 0.02 * |
| Chronic Kidney Disease | 91.23 | (70.22 – 112.24) | 79.52 | (64.28 – 94.76) | −12.84 | 72.66 | (57.50 – 87.82) | −8.62 | 101.45 | (79.23 – 123.67) | 39.62 | 0.06 | 0.76 |
| Chronic Obstructive Pulmonary Disease | 26.40 | (22.66 – 30.13) | 28.72 | (24.63 – 32.82) | 8.80 | 35.22 | (30.20 – 40.23) | 22.61 | 35.89 | (30.62 – 41.17) | 1.93 | 0.92 | 0.04 * |
| Diabetes | 63.89 | (53.73 – 74.06) | 76.25 | (64.91 – 87.58) | 19.34 | 81.04 | (70.02 – 92.07) | 6.29 | 97.04 | (83.66 – 110.42) | 19.74 | 0.96 | 0.02 * |
| Hypertension | 218.73 | (194.95 – 242.51) | 218.79 | (196.14 – 241.44) | 0.03 | 216.62 | (192.64 – 240.61) | −0.99 | 244.33 | (219.86 – 268.80) | 12.79 | 0.53 | 0.27 |
| None | 283.41 | (251.24 – 315.58) | 344.88 | (303.15 – 386.61) | 21.69 | 350.48 | (304.71 – 396.25) | 1.62 | 376.44 | (331.26 – 421.62) | 7.41 | 0.87 | 0.07 |
| ≥ 2 Comorbidities | 465.93 | (418.32 – 513.54) | 519.03 | (468.90 – 569.16) | 11.40 | 555.75 | (509.30 – 602.21) | 7.08 | 633.44 | (578.08 – 688.79) | 13.98 | 0.98 | 0.01 * |
| Spread of Cancer & Metastases | |||||||||||||
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| Chemotherapy | 61.55 | (51.02 – 72.08) | 69.69 | (59.79 – 79.60) | 13.23 | 77.38 | (65.67 – 89.08) | 11.02 | 88.00 | (77.03 – 98.97) | 13.73 | 0.99 | 0.003 ** |
| Gastrointestinal Metastasis | 51.06 | (45.31 – 56.81) | 54.02 | (47.63 – 60.41) | 5.80 | 68.72 | (46.28 – 91.17) | 27.21 | 53.37 | (46.51 – 60.22) | −22.34 | 0.12 | 0.65 |
| Lymph Node Metastasis | 23.23 | (17.65 – 28.81) | 20.81 | (17.18 – 24.43) | −10.44 | 23.18 | (18.59 – 27.77) | 11.41 | 32.37 | (25.71 – 39.04) | 39.67 | 0.57 | 0.25 |
| No Spread | 869.52 | (776.49 – 962.55) | 949.87 | (852.63 – 1,047.12) | 9.24 | 962.12 | (867.11 – 1,057.13) | 1.29 | 1,095.99 | (985.96 – 1,206.01) | 13.91 | 0.90 | 0.05 * |
| Non-Gastrointestinal Metastasis | 102.63 | (93.09 – 112.16) | 116.65 | (105.82 – 127.49) | 13.67 | 123.54 | (112.87 – 134.21) | 5.90 | 163.06 | (148.46 – 177.67) | 31.99 | 0.88 | 0.06 |
| ≥ 2 Spread Types | 61.05 | (52.94 – 69.17) | 79.16 | (62.19 – 96.13) | 29.65 | 91.76 | (75.95 – 107.57) | 15.92 | 93.53 | (80.35 – 106.71) | 1.93 | 0.90 | 0.05 |
| ≥ 3 Spread Types | 11.16 | (7.73 – 14.58) | 15.64 | (11.74 – 19.54) | 40.18 | 15.93 | (12.23 – 19.63) | 1.84 | 19.55 | (13.33 – 25.78) | 22.78 | 0.91 | 0.04 * |
| ≥ 4 Spread Types | 0.71 | (0.12 – 1.30) | 2.14 | (1.20 – 3.08) | 203.05 | 2.91 | (1.41 – 4.42) | 36.04 | 2.08 | (0.93 – 3.22) | −28.71 | 0.47 | 0.31 |
| Type of PLC | |||||||||||||
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| Cholangiocarcinoma | 325.98 | (296.29 – 355.67) | 360.76 | (322.78 – 398.75) | 10.67 | 402.03 | (365.60 – 438.46) | 11.44 | 472.39 | (427.43 – 517.35) | 17.50 | 0.97 | 0.01 * |
| Hepatocellular Carcinoma | 849.82 | (753.15 – 946.49) | 940.90 | (844.32 – 1,037.48) | 10.72 | 954.70 | (855.92 – 1,053.48) | 1.47 | 1,065.99 | (955.62 – 1,176.37) | 11.66 | 0.93 | 0.04 * |
| Mixed Hepatic Malignancy | 5.11 | (2.90 – 7.32) | 6.33 | (4.75 – 7.90) | 23.84 | 8.81 | (6.10 – 11.51) | 39.23 | 9.58 | (7.53 – 11.62) | 8.72 | 0.96 | 0.02 * |
| Types of Surgery | |||||||||||||
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| Tumor Ablation Complication | 19.67 | (15.65 – 23.69) | 22.04 | (16.38 – 27.71) | 12.07 | 16.37 | (11.93 – 20.81) | −25.76 | 14.02 | (11.19 – 16.85) | −14.31 | 0.68 | 0.18 |
| Hepatic Lobectomy | 26.61 | (21.78 – 31.44) | 31.46 | (21.67 – 41.26) | 18.25 | 34.08 | (28.27 – 39.90) | 8.32 | 42.30 | (33.56 – 51.03) | 24.10 | 0.95 | 0.02 * |
| Liver Transplant | 208.91 | (176.07 – 241.75) | 208.28 | (172.92 – 243.63) | −0.30 | 214.94 | (178.90 – 250.98) | 3.20 | 228.80 | (183.72 – 273.89) | 6.45 | 0.81 | 0.10 |
| No Surgery | 861.08 | (798.05 – 924.11) | 975.61 | (905.17 – 1,046.05) | 13.30 | 1,020.22 | (948.68 – 1,091.76) | 4.57 | 1,171.15 | (1,090.37 – 1,251.93) | 14.79 | 0.96 | 0.02 * |
| Partial Hepatectomy | 54.58 | (47.31 – 61.86) | 60.34 | (51.97 – 68.72) | 10.56 | 66.73 | (54.98 – 78.49) | 10.59 | 75.26 | (63.97 – 86.56) | 12.78 | 0.99 | 0.004 ** |
| Mixed Surgery Type | 10.06 | (6.96 – 13.15) | 10.25 | (7.50 – 13.01) | 1.94 | 13.20 | (6.52 – 19.89) | 28.78 | 16.42 | (4.32 – 28.52) | 24.37 | 0.90 | 0.05 * |
| Liver Complications | |||||||||||||
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| Ascites | 40.64 | (33.79 – 47.49) | 45.95 | (38.42 – 53.47) | 13.07 | 54.22 | (44.35 – 64.10) | 18.01 | 73.44 | (60.84 – 86.03) | 35.44 | 0.92 | 0.04 * |
| Encephalopathy | 8.75 | (6.74 – 10.77) | 10.03 | (7.52 – 12.55) | 14.64 | 13.34 | (10.40 – 16.27) | 32.92 | 15.14 | (11.56 – 18.72) | 13.51 | 0.97 | 0.01 * |
| Hepatocellular Carcinoma | 407.19 | (364.68 – 449.70) | 464.07 | (418.71 – 509.44) | 13.97 | 442.88 | (396.02 – 489.74) | −4.57 | 493.55 | (449.57 – 537.53) | 11.44 | 0.71 | 0.16 |
| Hepatorenal Syndrome | 1.14 | (0.43 – 1.85) | 1.85 | (0.58 – 3.13) | 62.61 | 2.58 | (1.16 – 4.00) | 39.08 | 8.60 | (3.98 – 13.22) | 233.63 | 0.76 | 0.13 |
| Varices | 3.05 | (1.87 – 4.23) | 3.86 | (2.04 – 5.67) | 26.40 | 3.61 | (2.45 – 4.77) | −6.39 | 4.03 | (3.21 – 4.84) | 11.54 | 0.66 | 0.19 |
| ≥ 2 Liver Complications | 279.43 | (241.06 – 317.80) | 305.51 | (269.94 – 341.08) | 9.33 | 327.88 | (288.41 – 367.36) | 7.32 | 365.02 | (316.38 – 413.65) | 11.32 | 0.99 | 0.006 ** |
| ≥ 3 Liver Complications | 135.68 | (112.98 – 158.37) | 142.09 | (122.19 – 161.99) | 4.73 | 151.99 | (131.97 – 172.02) | 6.97 | 175.57 | (150.25 – 200.88) | 15.51 | 0.91 | 0.04 * |
| ≥ 4 Liver Complications | 42.92 | (29.52 – 56.33) | 45.93 | (36.00 – 55.86) | 7.01 | 52.91 | (37.61 – 68.22) | 15.20 | 54.91 | (40.86 – 68.97) | 3.78 | 0.96 | 0.02 * |
| ≥ 5 Liver Complications | 3.81 | (1.34 – 6.28) | 6.14 | (3.37 – 8.91) | 61.12 | 4.59 | (3.21 – 5.98) | −25.21 | 4.51 | (2.22 – 6.79) | −1.86 | 0.01 | 0.93 |
| None | 258.29 | (235.98 – 280.61) | 282.55 | (254.68 – 310.43) | 9.39 | 311.53 | (286.62 – 336.43) | 10.25 | 353.19 | (321.69 – 384.69) | 13.37 | 0.98 | 0.008 ** |
| Liver Etiologies | |||||||||||||
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| Alcoholic Liver Disease | 94.54 | (80.91 – 108.17) | 113.82 | (99.92 – 127.72) | 20.39 | 129.37 | (109.82 – 148.92) | 13.66 | 141.24 | (120.62 – 161.86) | 9.18 | 0.99 | 0.006 ** |
| Autoimmune Hepatitis | 9.22 | (7.00 – 11.44) | 10.00 | (7.21 – 12.79) | 8.45 | 14.71 | (10.91 – 18.51) | 47.12 | 30.65 | (19.46 – 41.84) | 108.36 | 0.80 | 0.11 |
| Hepatitis B | 56.29 | (43.07 – 69.50) | 60.00 | (46.12 – 73.89) | 6.60 | 55.51 | (43.17 – 67.85) | −7.49 | 75.16 | (51.20 – 99.12) | 35.40 | 0.54 | 0.27 |
| Hepatitis C | 286.50 | (249.96 – 323.03) | 298.35 | (264.52 – 332.18) | 4.14 | 271.23 | (240.63 – 301.83) | −9.09 | 266.50 | (234.39 – 298.62) | −1.74 | 0.60 | 0.23 |
| Metabolic Liver Disease | 4.02 | (1.05 – 6.98) | 2.94 | (1.49 – 4.39) | −26.76 | 4.61 | (−0.27 – 9.49) | 56.74 | 2.92 | (1.40 – 4.44) | −36.70 | 0.06 | 0.75 |
| Non-Alcoholic Fatty Liver Disease | 63.92 | (50.87 – 76.98) | 75.63 | (63.14 – 88.11) | 18.31 | 95.74 | (76.42 – 115.06) | 26.60 | 103.98 | (88.75 – 119.20) | 8.60 | 0.98 | 0.01 * |
| Mixed Liver Etiology | 130.93 | (113.93 – 147.92) | 131.64 | (113.04 – 150.25) | 0.55 | 126.75 | (112.51 – 140.99) | −3.72 | 145.43 | (126.15 – 164.72) | 14.74 | 0.38 | 0.39 |
| Other | 535.49 | (490.24 – 580.75) | 615.61 | (557.66 – 673.56) | 14.96 | 667.62 | (608.73 – 726.52) | 8.45 | 782.08 | (717.56 – 846.61) | 17.14 | 0.98 | 0.01 * |
| Hospital Bed Size | |||||||||||||
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| Small | 108.27 | (95.12 – 121.43) | 128.69 | (111.79 – 145.60) | 18.86 | 141.50 | (125.07 – 157.93) | 9.95 | 160.90 | (144.83 – 176.97) | 13.71 | 0.99 | 0.004 ** |
| Medium | 221.91 | (183.31 – 260.51) | 266.76 | (230.09 – 303.44) | 20.21 | 310.85 | (262.15 – 359.55) | 16.53 | 308.37 | (270.49 – 346.25) | −0.80 | 0.87 | 0.07 |
| Large | 850.72 | (739.85 – 961.59) | 912.53 | (792.98 – 1,032.08) | 7.27 | 913.19 | (797.53 – 1,028.85) | 0.07 | 1,078.68 | (941.00 – 1,216.36) | 18.12 | 0.82 | 0.10 |
| Hospital Teaching Status | |||||||||||||
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| Nonteaching | 158.16 | (146.17 – 170.15) | 170.43 | (155.28 – 185.58) | 7.76 | 149.87 | (135.35 – 164.40) | −12.06 | 162.89 | (146.40 – 179.39) | 8.68 | 0.01 | 0.90 |
| Teaching | 1,022.74 | (905.22 – 1,140.27) | 1,137.56 | (1,012.28 – 1,262.83) | 11.23 | 1,215.66 | (1,089.93 – 1,341.40) | 6.87 | 1,385.06 | (1,242.32 – 1,527.81) | 13.93 | 0.98 | 0.01 * |
| Hospital Region | |||||||||||||
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| Northeast | 255.63 | (201.65 – 309.61) | 287.90 | (227.76 – 348.04) | 12.62 | 280.53 | (218.98 – 342.07) | −2.56 | 330.86 | (262.15 – 399.57) | 17.94 | 0.81 | 0.10 |
| Midwest | 205.39 | (164.90 – 245.88) | 227.56 | (178.76 – 276.36) | 10.79 | 256.01 | (197.10 – 314.92) | 12.50 | 290.54 | (227.28 – 353.80) | 13.49 | 0.99 | 0.005 ** |
| South | 370.06 | (313.32 – 426.80) | 387.57 | (333.62 – 441.53) | 4.73 | 418.21 | (360.45 – 475.97) | 7.90 | 482.61 | (413.06 – 552.15) | 15.40 | 0.92 | 0.04 * |
| West | 349.82 | (271.19 – 428.45) | 404.96 | (321.21 – 488.70) | 15.76 | 410.80 | (337.14 – 484.46) | 1.44 | 443.94 | (359.74 – 528.14) | 8.07 | 0.91 | 0.05 * |
| Insurance Type | |||||||||||||
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| Medicare | 592.00 | (535.86 – 648.14) | 667.30 | (602.30 – 732.29) | 12.72 | 709.09 | (645.99 – 772.18) | 6.26 | 838.98 | (759.46 – 918.50) | 18.32 | 0.95 | 0.02 * |
| Medicaid | 217.46 | (187.81 – 247.11) | 214.85 | (190.12 – 239.58) | −1.20 | 216.33 | (193.86 – 238.80) | 0.69 | 230.55 | (205.88 – 255.22) | 6.57 | 0.53 | 0.27 |
| Private | 302.79 | (260.40 – 345.18) | 353.20 | (306.21 – 400.20) | 16.65 | 371.72 | (317.15 – 426.30) | 5.24 | 382.20 | (331.58 – 432.81) | 2.82 | 0.89 | 0.06 |
| Other Insurance | 68.65 | (53.08 – 84.23) | 72.64 | (61.71 – 83.56) | 5.80 | 68.40 | (59.04 – 77.76) | −5.83 | 96.23 | (80.14 – 112.31) | 40.68 | 0.58 | 0.24 |
*
p < 0.05
**
p < 0.01
***
p < 0.001