Postgraduate Program in Pharmaceutical Science, Federal University of Paraná, Curitiba, Brazil.
School of Pharmaceutical Sciences, São Paulo State University, Araraquara, Brazil; Sustainability and Social Responsibility, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil.
Value Health Reg Issues. 2023 Jul;36:34-43. doi: 10.1016/j.vhri.2023.02.004. Epub 2023 Apr 3.
The severity and transmissibility of COVID-19 justifies the need to identify the factors associated with its cost of illness (CoI). This study aimed to identify CoI, cost predictors, and cost drivers in the management of patients with COVID-19 from hospital and Brazil's Public Health System (SUS) perspectives.
This is a multicenter study that evaluated the CoI in patients diagnosed of COVID-19 who reached hospital discharge or died before being discharged between March and September 2020. Sociodemographic, clinical, and hospitalization data were collected to characterize and identify predictors of costs per patients and cost drivers per admission.
A total of 1084 patients were included in the study. For hospital perspective, being overweight or obese, being between 65 and 74 years old, or being male showed an increased cost of 58.4%, 42.9%, and 42.5%, respectively. From SUS perspective, the same predictors of cost per patient increase were identified. The median cost per admission was estimated at US$359.78 and US$1385.80 for the SUS and hospital perspectives, respectively. In addition, patients who stayed between 1 and 4 days in the intensive care unit (ICU) had 60.9% higher costs than non-ICU patients; these costs significantly increased with the length of stay (LoS). The main cost driver was the ICU-LoS and COVID-19 ICU daily for hospital and SUS perspectives, respectively.
The predictors of increased cost per patient at admission identified were overweight or obesity, advanced age, and male sex, and the main cost driver identified was the ICU-LoS. Time-driven activity-based costing studies, considering outpatient, inpatient, and long COVID-19, are needed to optimize our understanding about cost of COVID-19.
COVID-19 的严重性和传染性使其有必要确定与疾病经济负担（CoI）相关的因素。本研究旨在从医院和巴西公共卫生系统（SUS）的角度确定 COVID-19 患者管理的 CoI、成本预测因素和成本驱动因素。
这是一项多中心研究，评估了 2020 年 3 月至 9 月期间因 COVID-19 住院并出院或在出院前死亡的患者的 CoI。收集社会人口统计学、临床和住院数据，以对患者进行特征描述并确定每位患者的成本预测因素和每次入院的成本驱动因素。
共有 1084 名患者纳入本研究。从医院角度来看，超重或肥胖、65-74 岁以及男性患者的成本分别增加了 58.4%、42.9%和 42.5%。从 SUS 角度来看，患者的成本预测因素相同。每例患者的平均住院费用分别为 SUS 视角的 359.78 美元和医院视角的 1385.80 美元。此外，在重症监护病房（ICU）住院 1-4 天的患者比非 ICU 患者的成本高出 60.9%；这些成本随着住院时间（LoS）的延长而显著增加。主要成本驱动因素是 ICU-LoS 和 COVID-19 ICU 日费用，分别是医院和 SUS 视角的主要成本驱动因素。
确定的入院时每位患者成本增加的预测因素为超重或肥胖、年龄较大和男性，主要成本驱动因素为 ICU-LoS。需要进行基于时间的作业成本法研究，包括门诊、住院和长期 COVID-19，以优化我们对 COVID-19 成本的理解。
