Laboratory for Research, Education and Planning in Critical and Intensive Care Medicine, CTS-609 Research Group, Poniente University Hospital, 04700 El Ejido, Spain.
Economic-Financial Directorate, Alto Guadalquivir Health Agency, 23740 Andujar, Spain.
Int J Environ Res Public Health. 2022 Dec 2;19(23):16132. doi: 10.3390/ijerph192316132.
(1) Background: The global health crisis caused by the coronavirus disease (COVID-19) pandemic has led to extreme overloading of different public healthcare systems worldwide. The Spanish Public Healthcare System is one of them. This study aimed to conduct a comparative cost analysis to assess the impact of the COVID-19 pandemic on small- and medium-sized regional hospitals in Andalusia (Spain). (2) Methods: This comparative, multicentre, observational, and retrospective study was designed to perform a comparative cost analysis between the Alto Guadalquivir Health Agency (AGHA) and Poniente University Hospital (PUH), both of which belong to the Spanish Public Health System (PHS). The data included in this study corresponds to the total costs by area and year incurred by the 61,335 patients from both healthcare institutions (AGHA = 36,110; PUH = 25,225) in the areas of hospital emergency service (HES), hospitalisation, and intensive care unit (ICU), during the 24 months of the study period (from 1 January 2019 to 31 December 2020). (3) Results: The analysis results showed a significant increase in costs incurred in 2020 for HES relative to those incurred in 2019 for both AGHA (+14%; p < 0.003) and PUH (+36%; p = 0.002). Additionally, costs incurred for ICU increased significantly in 2020 relative to those incurred in 2019 for both AGHA (+30%; p = 0.003) and PUH (+46%; p = 0.002). Hospitalisation costs for AGHA also increased significantly (+9%; p < 0.012) in 2020 versus those obtained in 2019; however, no significant differences were found for PUH (+6%; p = 1) in the same period analysed. However, the number of patients treated in the areas of HES, hospitalisation, and ICU was significantly reduced throughout 2020 compared to 2019. (4) Conclusions: Our findings show that the costs incurred during 2020 in the regional hospitals of Andalusia (Spain) increased significantly in most of the parameters analysed relative to those incurred in the year before the pandemic (i.e., 2019).
（1）背景：由冠状病毒病（COVID-19）大流行引起的全球卫生危机导致全球不同的公共医疗系统负担过重。西班牙公共医疗系统就是其中之一。本研究旨在进行成本比较分析，以评估 COVID-19 大流行对安达卢西亚（西班牙）中小地区医院的影响。
（2）方法：这是一项比较、多中心、观察性和回顾性研究，旨在对属于西班牙公共卫生系统（PHS）的 Alto Guadalquivir 卫生局（AGHA）和 Poniente 大学医院（PUH）进行成本比较分析。本研究的数据包括在研究期间的 24 个月内，来自这两个医疗机构（AGHA = 36,110；PUH = 25,225）的 61,335 名患者的区域和年度总费用，这些患者来自医院急诊服务（HES）、住院和重症监护病房（ICU）。
（3）结果：分析结果显示，2020 年 AGHA 和 PUH 的 HES 成本与 2019 年相比均显著增加（AGHA：+14%；p < 0.003；PUH：+36%；p = 0.002）。此外，AGHA 和 PUH 的 ICU 成本与 2019 年相比均显著增加（AGHA：+30%；p = 0.003；PUH：+46%；p = 0.002）。AGHA 的住院费用也显著增加（+9%；p < 0.012），而同期 PUH 则没有显著差异（+6%；p = 1）。然而，与 2019 年相比，2020 年 HES、住院和 ICU 治疗的患者数量均显著减少。
（4）结论：我们的研究结果表明，与大流行前一年（即 2019 年）相比，西班牙安达卢西亚地区医院在 2020 年发生的大多数参数的成本显著增加。
