OBJECTIVES: Hepatocellular carcinoma is one of the most prevalent cancers in Taiwan. Since Taiwan’s National Health Insurance (NHI) system neither prohibit patients from choosing health care facilities nor limit number of outpatient visits. Therefore, patients being diagnosed as having hepatocellular carcinoma may seek second or even third doctor to confirm their condition. Thus, the purpose of this study was to examine the effects of disease confirmation behavior on the medical utilization and expenditure for patients with hepatocellular carcinoma.  METHODS: Data came the Longitudinal Health Insurance Database, which consisted of one million subjects of randomly selected samples from the entire NHI enrollee profile for 2005 to 2007. We selected patients with hepatocellular carcinoma by using the ICD-9-CM codes (155, 155.0, and 155.2). Medical utilization and expenditure of those patients within three months after first being diagnosed as having hepatocellular carcinoma were extracted from the data set.   RESULTS: There were 1282 new hepatocellular carcinoma patients in our sample and 258 patients (20.12%) were identified as having the behavior of repeated disease confirmation. Total repeated physician fee and repeated examination were NT$1,272,765 and NT$3,783,983, respectively. (US$1=NT$31.86)The expenditure of examination in the first-repeated confirmation hospital was higher than that of first-diagnosis hospital (p<0.01). The expenditure was highly related to having Charlson comorbidity index score 2 or higher, received chemotherapy, embolization, surgical operation and confirmation in medical centers.    CONCLUSIONS: Within three months after first time being diagnosed, 20.1% of hepatocellular carcinoma patients used repeated medical services to reconfirm their disease. The expenditure of examination in the repeated visit was higher than that of the first time being diagnosed. Further investigation is needed to compare the long term health status of patients with and without repeated confirmation behavior.