McNaughton Candace D, Austin Peter C, Li Zhiyin, Sivaswamy Atul, Fang Jiming, Abdel-Qadir Husam, Udell Jacob A, Wodchis Walter P, Lee Douglas S, Mostarac Ivona, Atzema Clare L
ICES (Formerly, the Institute for Clinical Evaluative Sciences), Toronto, Ontario, Canada.
Sunnybrook Research Institute, Toronto, Ontario, Canada.
J Multidiscip Healthc. 2024 Dec 5;17:5749-5761. doi: 10.2147/JMDH.S465154. eCollection 2024.
Growing evidence suggests SARS-CoV-2 infection increases the risk of long term cardiovascular, neurological, and other effects. However, post-acute health care costs following SARS-CoV-2 infection are not known.
Beginning 56 days following SARS-CoV-2 polymerase chain reaction (PCR) testing, we compared person-specific total and component health care costs (2020 CAD$) for the first year of follow-up at the mean and 99 percentiles of health care costs for matched test-positive and test-negative adults in Ontario, Canada, between January 1, 2020, and March 31, 2021. Matching included demographics, baseline clinical characteristics, and two-week time blocks.
For 531,182 people, mean person-specific total health care costs were $513.83 (95% CI $387.37-$638.40) higher for test-positive females and $459.10 (95% CI $304.60-$615.32) higher for test-positive males, which were driven by hospitalization, long-term care, and complex continuing care costs. At the 99 percentile of each subgroup, person-specific health care costs were $12,533.00 (95% CI $9008.50-$16,473.00) higher for test-positive females and $14,604.00 (95% CI $9565.50-$19,506.50) for test-positive males, driven by hospitalization, specialist (males), and homecare costs (females). Cancer costs were lower. Six-month and 1-year cost differences were similar.
Post-acute health care costs after a positive SARS-CoV-2 PCR test were significantly higher than matched test-negative individuals, and these increased costs persisted for at least one year. The largest increases health care costs came from hospitalizations, long-term care, complex continuing care, followed by outpatient specialists (for males) and homecare costs (for women). Given the magnitude of ongoing viral spread, policymakers, clinicians, and patients should be aware of higher post-acute health care costs following SARS-CoV-2 infection.
越来越多的证据表明，感染新冠病毒（SARS-CoV-2）会增加长期心血管、神经及其他方面影响的风险。然而，新冠病毒感染后的急性后期医疗保健费用尚不清楚。
自新冠病毒聚合酶链反应（PCR）检测56天后开始，我们比较了2020年1月1日至2021年3月31日期间，加拿大安大略省匹配的新冠病毒检测呈阳性和检测呈阴性的成年人在随访第一年按人均计算的总医疗保健费用及各项费用（以2020年加元计），分别处于医疗保健费用均值和第99百分位数的情况。匹配因素包括人口统计学特征、基线临床特征以及两周时间区间。
对于531,182人，检测呈阳性的女性人均总医疗保健费用比匹配的检测呈阴性女性高513.83加元（95%置信区间为387.37 - 638.40加元），检测呈阳性的男性人均总医疗保健费用比匹配的检测呈阴性男性高459.10加元（95%置信区间为304.60 - 615.32加元），这些差异主要由住院、长期护理及复杂的持续护理费用导致。在每个亚组的第99百分位数水平，检测呈阳性的女性人均医疗保健费用比匹配的检测呈阴性女性高12,533.00加元（95%置信区间为9008.50 - 16,473.00加元），检测呈阳性的男性人均医疗保健费用比匹配的检测呈阴性男性高14,604.00加元（95%置信区间为9565.50 - 19,506.50加元），主要由住院、专科医疗费用（男性）及家庭护理费用（女性）导致。癌症相关费用较低。6个月和1年的费用差异相似。
新冠病毒PCR检测呈阳性后的急性后期医疗保健费用显著高于匹配的检测呈阴性个体，且这些增加的费用至少持续了一年。医疗保健费用增加最多的方面是住院、长期护理、复杂的持续护理，其次是门诊专科医疗费用（男性）和家庭护理费用（女性）。鉴于病毒仍在持续广泛传播，政策制定者、临床医生和患者应意识到新冠病毒感染后急性后期医疗保健费用会更高。
