Department of Anaesthesia and Intensive Care, Fundeni Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, 022328 Bucharest, Romania.
Department of Anaesthesia and Intensive Care, Fundeni Clinical Institute, 022328 Bucharest, Romania.
Int J Environ Res Public Health. 2022 Feb 4;19(3):1781. doi: 10.3390/ijerph19031781.
The COVID-19 pandemic has been associated with a tremendous financial and social impact. The pressure on healthcare systems worldwide has increased with each pandemic wave. The present study assesses the impact of the COVID-19 pandemic on healthcare-derived costs of critically ill patients during the fourth wave of the COVID-19 pandemic in a tertiary hospital in Romania. We prospectively included patients admitted to a single-centre intensive care unit (ICU) during the fourth wave of the COVID-19 pandemic. Median daily costs were calculated from financial records and divided in three groups: administrative costs, treatment costs and investigation costs. These were then compared to two retrospective cohorts of non-COVID-19 patients admitted to the same ICU during the same time interval in 2020 and 2019. Demographic data and the management of SARS-CoV-2 infection and of associated organ dysfunctions were recorded to identify risk factors for higher costs. Our results show that the COVID-19 pandemic has been associated with a 70.8% increase in total costs compared to previous years. This increase was mainly determined by an increase in medication and medical-device-related costs. We identified the following as risk factors for increased costs: higher degrees of lung involvement, severity of respiratory dysfunction, need for renal replacement therapy and the use of antiviral or immunomodulatory therapy. Costs were higher in patients who had a shorter duration of hospitalization. In conclusion, the COVID-19 pandemic is associated with increased costs for patients, and rapid measures need to be taken to ensure adequate financial support during future pandemic waves, especially in developing countries.
COVID-19 大流行对全球医疗保健系统造成了巨大的财务和社会影响。随着每一波大流行的到来，医疗系统的压力都在增加。本研究评估了 COVID-19 大流行在罗马尼亚一家三级医院第四波大流行期间对重症患者医疗保健相关成本的影响。我们前瞻性地纳入了在 COVID-19 大流行第四波期间入住单中心重症监护病房（ICU）的患者。从财务记录中计算出每日的中位数成本，并将其分为三组：行政成本、治疗成本和调查成本。然后将其与在同一 ICU 中于同一时间段内 2020 年和 2019 年入住的两组非 COVID-19 患者的回顾性队列进行比较。记录人口统计学数据以及 SARS-CoV-2 感染和相关器官功能障碍的治疗，以确定导致更高成本的风险因素。我们的结果表明，与前几年相比，COVID-19 大流行导致总费用增加了 70.8%。这种增加主要是由药物和医疗器械相关费用的增加引起的。我们确定以下因素是导致成本增加的风险因素：肺部受累程度更高、呼吸功能障碍的严重程度、需要肾脏替代治疗以及使用抗病毒或免疫调节治疗。住院时间较短的患者成本更高。总之，COVID-19 大流行与患者成本增加有关，需要采取快速措施，以确保在未来的大流行浪潮中提供足够的财政支持，尤其是在发展中国家。
