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Am J Manag Care. 2023 Oct;29(10):509-514. doi: 10.37765/ajmc.2023.89439.
To estimate payments for the treatment of COVID-19 compared with that of influenza or viral pneumonia (IP), from the perspective of the US payer.
Retrospective cohort analysis.
Patients with COVID-19 during the period from October 1, 2020, to February 1, 2021, or IP during the period from October 1, 2018, to February 1, 2019, in the IBM MarketScan databases were identified. The index was defined as the date of the first COVID-19 or IP diagnosis. Patients with COVID-19 were stratified by severity. Variables for all patients included demographics and comorbidities at the time of index and duration of disease. IP and COVID-19 cohorts were matched using propensity scores, and inflation-adjusted all-cause payments (ACP), and disease-specific payments (DSP) for IP vs COVID-19 were estimated using generalized linear models.
Matched cohorts included 6332 Medicare (female, 58.5%; mean [SD] age, 75.3 [7.6] years), and 397,532 commercially insured patients (female, 57.6%; mean [SD] age, 34.7 [16.7] years). ACP and DSP were significantly higher in the COVID-19 cohort vs IP cohort. Payments for severe/critical COVID-19 were significantly greater than those for IP, with adjusted marginal incremental DSP and ACP of $24,852 (95% CI, $21,573-$28,132) and $50,325 (95% CI, $43,932-$56,718), respectively. IP was significantly less expensive than moderate COVID-19 for commercial payers but not Medicare. IP was more expensive than mild COVID-19 for all payers.
Payments associated with severe/critical COVID-19 significantly exceeded those associated with IP. For Medicare, IP was more expensive than mild or moderate COVID-19. For commercial payers, IP was less expensive than moderate COVID-19 but more expensive than mild COVID-19.
从美国支付方的角度估计 COVID-19 治疗费用与流感或病毒性肺炎（IP）治疗费用的对比。
回顾性队列分析。
在 IBM MarketScan 数据库中，确定了 2020 年 10 月 1 日至 2021 年 2 月 1 日期间患有 COVID-19 的患者或 2018 年 10 月 1 日至 2019 年 2 月 1 日期间患有 IP 的患者。指数定义为 COVID-19 或 IP 首次诊断的日期。根据严重程度对 COVID-19 患者进行分层。所有患者的变量包括指数时的人口统计学特征和合并症以及疾病持续时间。使用倾向评分匹配 COVID-19 与 IP 患者，使用广义线性模型估计 IP 与 COVID-19 的通胀调整全因支付（ACP）和疾病特异性支付（DSP）。
匹配队列包括 6332 名 Medicare（女性占 58.5%；平均[标准差]年龄为 75.3[7.6]岁）和 397,532 名商业保险患者（女性占 57.6%；平均[标准差]年龄为 34.7[16.7]岁）。COVID-19 队列的 ACP 和 DSP 明显高于 IP 队列。严重/危重症 COVID-19 的支付明显高于 IP，调整后的边际增量 DSP 和 ACP 分别为 24852 美元（95%CI，21573 美元至 28132 美元）和 50325 美元（95%CI，43932 美元至 56718 美元）。对于商业支付方，IP 比中度 COVID-19 的费用更低，但 Medicare 并非如此。对于所有支付方，IP 比轻度 COVID-19 的费用更高。
严重/危重症 COVID-19 相关的支付明显高于 IP。对于 Medicare，IP 比轻度或中度 COVID-19 的费用更高。对于商业支付方，IP 比中度 COVID-19 的费用更低，但比轻度 COVID-19 的费用更高。
