Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel
Branch of Planning and Strategy, Clalit Health Services, Tel Aviv, Israel.
BMJ Glob Health. 2023 Jul;8(7). doi: 10.1136/bmjgh-2023-012588.
Postacute sequelae resulting from SARS-CoV-2 infections (LONG-COVID) have been reported. The resulting added economic burden from the perspective of healthcare organisations is not clear. Therefore, this study aims to evaluate the additive healthcare costs among COVID-19 recoverees, in a large community-dwelling general population, as incurred by an insurer-provider organisation over time.
In this historical cohort study, cost data from Clalit Health Services (CHS) were analysed. The primary endpoint was the direct cost incurred by CHS per month per person. Costs were measured for COVID-19 recoverees and matched controls, from January 2019 to January 2022. Difference in differences (DiDs) were calculated as the difference in mean monthly costs in cases and controls in the post-COVID-19 individual period, deducing their cost difference in a prepandemic 12 months baseline period.
Among N=642 868 community-dwelling COVID-19 recoverees, 268 948 (40.8%) were 0-19 years old and 63 051 (9.6%) were 60 years or older. A total of 16 017 (2.5%) of recoverees had been hospitalised during the acute phase of the COVID-19 disease. Costs in cases and controls converged after 16 months from recovery. The mean monthly cost incurred by CHS per COVID-19 recoverees over up to 15 months (mean: 8.25) of post-COVID-19 follow-up was higher by 8.2% (US$8.2) compared with matched controls. The excess cost attributable to post-COVID-19 effects (DID) was 7.6% of the cost in controls (US$7.7 per patient per month). Both net and relative DIDs were substantially higher in patients who required hospitalisation during the acute phase of COVID-19 and in older adults. Excess in hospitalisations, primary care physicians and medical specialists' visits-related costs were observed.
Long-term effects of SARS-CoV-2 infections translate into excess healthcare costs, months after recovery, hence requiring adjustments of funds allocation. These excess costs gradually diminish after recoveree, returning to baseline differences 16 months after recoveree.
已报道 SARS-CoV-2 感染后出现的后遗症（长新冠）。但目前尚不清楚医疗保健组织从角度来看由此产生的额外经济负担。因此，本研究旨在评估在大型社区居住的一般人群中，随着时间的推移，保险公司/提供者组织中 COVID-19 康复者的附加医疗成本。
在这项回顾性队列研究中，分析了 Clalit 健康服务（CHS）的数据。主要终点是 CHS 每个月为每个人支付的直接成本。从 2019 年 1 月至 2022 年 1 月，对 COVID-19 康复者和匹配对照者进行了成本测量。差异（DiD）的计算方法是在 COVID-19 个体期间病例和对照的平均每月成本之间的差异，减去流行前 12 个月基线期的成本差异。
在 642868 名居住在社区的 COVID-19 康复者中，268948 名（40.8%）年龄在 0-19 岁之间，63051 名（9.6%）年龄在 60 岁或以上。共有 16017 名（2.5%）康复者在 COVID-19 疾病的急性期住院。康复后 16 个月，病例和对照者的成本趋同。在 COVID-19 后长达 15 个月（平均：8.25）的随访期间，CHS 为每位 COVID-19 康复者支付的月平均成本高出 8.2%（8.2 美元），比匹配的对照者高。归因于 COVID-19 后效应的超额费用（DID）占对照者成本的 7.6%（每位患者每月 7.7 美元）。在 COVID-19 急性期需要住院治疗的患者和老年人中，净和相对 DID 均明显更高。观察到与住院、初级保健医生和医学专家就诊相关的费用增加。
SARS-CoV-2 感染的长期影响导致康复后数月内医疗保健费用增加，因此需要调整资金分配。这些超额费用在康复后逐渐减少，在康复后 16 个月恢复到基线差异。
