TABLE 4.
Length of hospital stay, clinical outcomes, payer and hospital charges of HCC-related hospitalizations in the United States from 2002–2011.
| 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | Slope | P Value | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Length-of-stay [days, mean (SE)] | ||||||||||||
| Overall HCC-related | 6.5 (0.2) | 6.3 (0.3) | 6.2 (0.2) | 6.4 (0.2) | 6.0 (0.1) | 5.9 (0.1) | 6.0 (0.2) | 5.8 (0.1) | 5.8 (0.1) | 5.6 (0.1) | −0.090 | <0.001 |
| Primary diagnosis | 7.1 (0.2) | 6.9 (0.3) | 6.9 (0.4) | 6.8 (0.4) | 6.4 (0.1) | 6.1 (0.2) | 6.4 (0.2) | 6.2 (0.1) | 5.9 (0.2) | 5.9 (0.2) | −0.138 | <0.001 |
| Secondary diagnosis | 6.0 (0.2) | 5.8 (0.3) | 5.6 (0.2) | 6.2 (0.2) | 5.7 (0.2) | 5.8 (0.2) | 5.8 (0.2) | 5.6 (0.2) | 5.7 (0.1) | 5.5 (0.2) | −0.038 | 0.091 |
| Patient disposition (%) | ||||||||||||
| Routine discharge to home | 62.6 | 60.8 | 59.0 | 57.1 | 57.4 | 57.0 | 58.7 | 57.1 | 55.5 | 55.4 | −0.648 | 0.001 |
| Short-term hospital | 1.9 | 2.0 | 2.2 | 2.1 | 2.6 | 2.6 | 2.3 | 2.5 | 2.6 | 2.5 | 0.071 | 0.005 |
| Skilled nursing facility | 9.5 | 9.7 | 10.4 | 11.7 | 11.5 | 12.3 | 11.5 | 12.3 | 13.1 | 13.3 | 0.410 | <0.001 |
| Home healthcare | 11.6 | 13.8 | 14.5 | 15.5 | 15.3 | 15.8 | 16.4 | 16.4 | 17.9 | 18.1 | 0.605 | <0.001 |
| Against medical advice | 0.7 | 0.5 | 0.6 | 0.6 | 0.5 | 0.7 | 0.7 | 0.8 | 0.8 | 0.7 | 0.021 | 0.061 |
| Other (alive but destination unknown, died, etc.) | 13.7 | 13.2 | 13.3 | 13 | 12.7 | 11.6 | 10.4 | 10.9 | 10.1 | 10 | −0.460 | <0.001 |
| In-hospital mortality (%) | ||||||||||||
| Overall HCC-related | 13.5 | 13.1 | 13.1 | 12.5 | 12.4 | 11.3 | 10.3 | 10.4 | 9.6 | 9.9 | −0.470 | <0.001 |
| Primary diagnosis | 17.0 | 16.1 | 17.0 | 16.0 | 15.0 | 12.3 | 11.8 | 11.8 | 11.0 | 9.8 | −0.859 | <0.001 |
| Secondary diagnosis | 10.7 | 10.7 | 10.0 | 9.9 | 10.6 | 10.6 | 9.4 | 9.6 | 8.9 | 9.9 | −0.141 | 0.027 |
| Primary expected payer (%) | ||||||||||||
| Medicare | 44.4 | 44.3 | 44.2 | 44.9 | 43.1 | 45.7 | 42.8 | 43.2 | 43.7 | 45.4 | −0.023 | 0.841 |
| Medicaid | 16.3 | 17.4 | 16.3 | 16.4 | 18.0 | 16.1 | 18.0 | 18.4 | 19.2 | 19.4 | 0.327 | 0.006 |
| Private insurance (including HMO) | 32.2 | 32.1 | 32.9 | 31.1 | 28.9 | 30.0 | 31.9 | 29.5 | 29.0 | 26.7 | −0.513 | 0.006 |
| Self-pay | 3.9 | 2.7 | 3.4 | 4.1 | 4.2 | 3.5 | 3.2 | 4.7 | 4.0 | 3.7 | 0.063 | 0.343 |
| Others | 3.2 | 3.5 | 4.3 | 3.5 | 5.8 | 4.7 | 4.1 | 4.2 | 4.1 | 4.8 | 0.114 | 0.186 |
| Total charges [$, mean (SE)] | ||||||||||||
| Overall HCC-related | 32,405 (2,667.7) | 37,783 (3,400.7) | 35,070 (2,511.8) | 42,612 (3,336.8) | 38,093 (2,716.1) | 46,010 (3,602.7) | 54,820 (4,373.7) | 58,048 (4,600.5) | 57,686 (3,951.3) | 59,465 (4,487.8) | 3,286.6 | <0.001 |
| Primary diagnosis | 33188 (2,842.4) | 38028 (2,767.7) | 36468 (2,544.0) | 43271 (3,401.9) | 39359 (2,163.2) | 44921 (2,862.6) | 56404 (3,667.6) | 62514 (5,146.7) | 58293 (3,500.0) | 64397 (5,481.7) | 3,623.8 | <0.001 |
| Secondary diagnosis | 31,767 (2,716.3) | 37,588 (4,399.2) | 34,014 (2,717.3) | 42,111 (3,794.6) | 37,218 (3,363.3) | 46,739 (4,298.2) | 53,882 (5,076.8) | 55,523 (4,652.9) | 57,379 (4,412.5) | 57,128 (4,362.0) | 3,146.5 | <0.001 |
HCC, hepatocellular carcinoma; HMO, Health Maintenance Organization; SE, standard error.