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在美国一个全支付方行政数据集中比较流感或新冠病毒感染住院后的急性后期护理医疗费用:一项回顾性队列研究。

Comparing postacute care healthcare charges after hospitalisation due to influenza or COVID-19 infection in an all-payer administrative dataset in the USA: a retrospective cohort study.

作者信息

Bailey Joseph, Alexandria Shaina J, Hu Blair, Wolfe Lisa F, Welty Leah J, Kruser Jacqueline M, Kalhan Ravi

机构信息

Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

出版信息

BMJ Public Health. 2023 Jul 24;1(1):e000102. doi: 10.1136/bmjph-2023-000102. eCollection 2023 Nov.

Abstract

OBJECTIVE

SARS-CoV-2 infection often causes a persistent syndrome of multiorgan dysfunction with symptoms that may be debilitating. Individuals seeking care for this syndrome are likely to generate significant healthcare utilisation and spending. It is unknown if healthcare costs after SARS-CoV-2 infection differ from those after influenza infection.

METHODS AND ANALYSIS

We used an all-payer administrative dataset comprised coding and billing data from 446 hospitals in the USA that use a financial analytics platform by Strata Decision Technology. The deidentified analytical sample included patients aged 18 years or older who were admitted to a hospital between July 2018 and May 2021 with an International Classification of Disease-10 code for COVID-19 or influenza. Analyses were stratified by age (18-44, 45-64 and 65+) and need for ventilation during acute hospitalisation. Linear regression models were used to evaluate the relationship between infection type (COVID-19 or influenza) and cumulative charges between 1 and 5 months after hospitalisation. Independent variables included medical comorbidities, health system classification and prehospitalisation charges, among others.

RESULTS

Of 110 381 patients included in our analysis, 94 927 (86.0%) were hospitalised for COVID-19 and 15 454 (14.0%) were hospitalised for influenza. Patients hospitalised for COVID-19 generated a median of US$5248 (inter-quartile range (IQR) US$25693) in postacute healthcare charges, whereas patients hospitalised for influenza generated a median of US$8463 (IQR US$41063). Compared with influenza, linear model results demonstrated no significant differences in postacute charges among patients hospitalised with COVID-19.

CONCLUSION

Our findings suggest that individual healthcare expenditures after acute COVID-19 infection are not significantly different from those after influenza infection.

摘要

目的

严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染常导致多器官功能障碍的持续综合征,其症状可能使人虚弱。因该综合征寻求治疗的个体可能会产生大量的医疗服务利用和支出。目前尚不清楚SARS-CoV-2感染后的医疗费用与流感感染后的医疗费用是否不同。

方法与分析

我们使用了一个全支付方行政数据集,该数据集包含美国446家使用Strata Decision Technology财务分析平台的医院的编码和计费数据。经过去识别处理的分析样本包括2018年7月至2021年5月期间因COVID-19或流感的国际疾病分类第10版编码而入院的18岁及以上患者。分析按年龄(18 - 44岁、45 - 64岁和65岁及以上)以及急性住院期间是否需要通气进行分层。线性回归模型用于评估感染类型(COVID-19或流感)与住院后1至5个月累积费用之间的关系。自变量包括医疗合并症、卫生系统分类和住院前费用等。

结果

在我们分析纳入的110381例患者中,94927例(86.0%)因COVID-19住院,15454例(14.0%)因流感住院。因COVID-19住院的患者在急性后期医疗费用方面的中位数为5248美元(四分位间距(IQR)为25693美元),而因流感住院的患者中位数为8463美元(IQR为41063美元)。与流感相比,线性模型结果显示,COVID-19住院患者的急性后期费用没有显著差异。

结论

我们的研究结果表明,急性COVID-19感染后的个人医疗支出与流感感染后的支出没有显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/814b/11812709/627fdd1ba430/bmjph-1-1-g001.jpg

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