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美国 XBB 和 JN.1 奥密克戎亚谱系流行期间,COVID-19 相关住院患者的健康结局和经济负担。

Health outcomes and economic burden among patients with a COVID-19-associated hospitalization in the United States during the predominance of the XBB and JN.1 omicron lineages.

机构信息

Pfizer Inc, New York, USA.

Evidera Inc, Bethesda, USA.

出版信息

J Med Econ. 2024 Jan-Dec;27(1):1372-1378. doi: 10.1080/13696998.2024.2416873. Epub 2024 Oct 26.

DOI:10.1080/13696998.2024.2416873
PMID:39429025
Abstract

OBJECTIVE

Conduct a comprehensive analysis of the health and economic outcomes of patients with a COVID-19-associated hospitalization in the US during the predominance of the XBB and JN.1 Omicron lineages.

METHODS

This analysis used data from the PINC AI Healthcare Database (PHD) for all patients with a hospital admission date occurring between February 4, 2023, and February 29, 2024 with an ICD-10-CM code U07.1 "COVID-19" in any position. The data were used to estimate the mean and median length of stay (LOS), mean and median hospitalization cost, and proportion of patients that died in the hospital, by age and level of care (normal ward, intensive care [ICU], invasive mechanical ventilation [IMV]).

RESULTS

LOS, hospitalization costs, and inpatient mortality increased with both the level of care and age. Patients not receiving ICU care had the shortest LOS, lowest inpatient mortality, and lowest hospitalization costs. LOS, hospitalization costs, and inpatient mortality were higher for those receiving ICU care and highest for those receiving IMV in the ICU. Within each level of care (normal ward, ICU without IMV, and ICU with IMV), the LOS, inpatient mortality, and hospitalization cost generally increased with age, indicating that older adults with COVID-19 required a longer recovery period, have a higher likelihood of death, and accrue higher costs. However, the proportion of pediatric patients with an ICU admission and/or IMV usage remained high.

LIMITATIONS

The PHD data may not be representative of all hospitalized patients in the US.

CONCLUSIONS

These findings suggest that COVID-19 continues to have severe and costly consequences in all age groups, but particularly for older adults including long LOS, ICU admission, need for IMV, mortality, and high hospital costs.

摘要

目的

分析 2023 年 2 月 4 日至 2024 年 2 月 29 日期间,美国 XBB 和 JN.1 奥密克戎亚谱系流行期间 COVID-19 相关住院患者的健康和经济结局。

方法

本分析使用 PINC AI Healthcare 数据库(PHD)中的数据,纳入所有 2023 年 2 月 4 日至 2024 年 2 月 29 日期间因 COVID-19(任何位置 ICD-10-CM 编码 U07.1)住院的患者。用于估计平均和中位数住院时间(LOS)、平均和中位数住院费用,以及不同年龄和护理级别(普通病房、重症监护病房[ICU]、有创机械通气[IMV])患者的院内死亡率。

结果

LOS、住院费用和住院死亡率随护理水平和年龄的增加而增加。未接受 ICU 护理的患者 LOS 最短、院内死亡率最低、住院费用最低。未接受 ICU 护理的患者 LOS 最短、院内死亡率最低、住院费用最低。接受 ICU 护理的患者的 LOS、住院费用和院内死亡率更高,而在 ICU 接受 IMV 的患者最高。在每个护理级别(普通病房、无 IMV 的 ICU 和有 IMV 的 ICU)内,LOS、院内死亡率和住院费用通常随年龄增加而增加,这表明 COVID-19 老年患者需要更长的恢复期、更高的死亡率和更高的费用。然而,接受 ICU 入院和/或 IMV 使用的儿科患者比例仍然很高。

局限性

PHD 数据可能无法代表美国所有住院患者。

结论

这些发现表明 COVID-19 在所有年龄段都继续产生严重和昂贵的后果,但特别是对老年人,包括较长的 LOS、ICU 入院、需要 IMV、死亡率和高住院费用。

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