Brown University Department of Epidemiology, Box G-S121-2, 121 S Main St, Providence, RI 02903. Email:
Am J Manag Care. 2023 Nov;29(11):566-572. doi: 10.37765/ajmc.2023.89452.
To estimate excess health care costs in the 12 months following COVID-19 diagnosis.
Retrospective cohort study using Blue Cross Blue Shield of Rhode Island claims incurred from January 1, 2019, to March 31, 2022, among commercial and Medicare Advantage members.
Difference-in-differences analyses were used to compare changes in health care spend between the 12 months before (baseline period) and the 12 months after (post period) COVID-19 diagnosis for COVID-19 cases and contemporaneous matched controls without COVID-19.
Overall, there were 7224 commercial and 1630 Medicare Advantage members with a COVID-19 diagnosis on/before March 31, 2021, each with a matched control, yielding a sample of 14,448 commercial and 3260 Medicare Advantage members. Among commercial members, 51.9% were aged 25 to 54 years and 54.0% were female. Among Medicare Advantage members, 94.2% were 65 years or older and 62.0% were female. Among commercial members, from the baseline period to the post period, total health care spend increased $41.61 (7.7%) per member per month (PMPM) more among COVID-19 cases compared with their matched controls. Among Medicare Advantage members, the difference-in-differences was greater, with spend increasing $97.30 (13.1%) PMPM more among cases compared with controls. The difference-in-differences was greatest for outpatient and professional services (both populations) and prescription services (Medicare Advantage only).
COVID-19 diagnosis was associated with excess health care spend PMPM over the subsequent 12 months, highlighting the importance of societal preparations to support individuals' long-term health care needs following COVID-19 and as a part of future pandemic preparedness.
估计 COVID-19 诊断后 12 个月内的超额医疗保健费用。
这是一项使用罗德岛蓝十字蓝盾公司 2019 年 1 月 1 日至 2022 年 3 月 31 日期间商业和医疗保险优势计划成员的索赔数据进行的回顾性队列研究。
采用差值法比较 COVID-19 病例和同期无 COVID-19 的对照者在 COVID-19 诊断前 12 个月（基线期）和诊断后 12 个月（后疫情期）期间医疗保健支出的变化。
总体而言，在 2021 年 3 月 31 日之前有 7224 名商业和 1630 名医疗保险优势计划成员被诊断出 COVID-19，每位成员都有一名匹配对照者，共得到 14448 名商业和 3260 名医疗保险优势计划成员的样本。在商业成员中，51.9%的年龄在 25 至 54 岁之间，54.0%为女性。在医疗保险优势计划成员中，94.2%的年龄在 65 岁或以上，62.0%为女性。在商业成员中，从基线期到后疫情期，COVID-19 病例的每月每位成员总医疗保健支出比其匹配对照者增加了 41.61 美元（7.7%）。在医疗保险优势计划成员中，差异更大，病例比对照者每月的支出增加了 97.30 美元（13.1%）。差异在门诊和专业服务（两个群体）和处方服务（仅医疗保险优势计划）中最大。
COVID-19 诊断与随后 12 个月内的超额医疗保健支出有关，这突显了社会为支持个人在 COVID-19 后的长期医疗保健需求以及作为未来大流行准备工作的一部分所做的准备的重要性。
