TY - JOUR
T1 - Estimating the economic burden of long-Covid
T2 - the additive cost of healthcare utilisation among COVID-19 recoverees in Israel
AU - Wolff Sagy, Yael
AU - Feldhamer, Ilan
AU - Brammli-Greenberg, Shuli
AU - Lavie, Gil
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/7/18
Y1 - 2023/7/18
N2 - Introduction Postacute sequelae resulting from SARS-CoV-2 infections (LONG-COVID) have been reported. The resulting added economic burden from the perspective of healthcare organisations is not clear. Therefore, this study aims to evaluate the additive healthcare costs among COVID-19 recoverees, in a large community-dwelling general population, as incurred by an insurer-provider organisation over time. Methods In this historical cohort study, cost data from Clalit Health Services (CHS) were analysed. The primary endpoint was the direct cost incurred by CHS per month per person. Costs were measured for COVID-19 recoverees and matched controls, from January 2019 to January 2022. Difference in differences (DiDs) were calculated as the difference in mean monthly costs in cases and controls in the post-COVID-19 individual period, deducing their cost difference in a prepandemic 12 months baseline period. Results Among N=642 868 community-dwelling COVID-19 recoverees, 268 948 (40.8%) were 0-19 years old and 63 051 (9.6%) were 60 years or older. A total of 16 017 (2.5%) of recoverees had been hospitalised during the acute phase of the COVID-19 disease. Costs in cases and controls converged after 16 months from recovery. The mean monthly cost incurred by CHS per COVID-19 recoverees over up to 15 months (mean: 8.25) of post-COVID-19 follow-up was higher by 8.2% (US$8.2) compared with matched controls. The excess cost attributable to post-COVID-19 effects (DID) was 7.6% of the cost in controls (US$7.7 per patient per month). Both net and relative DIDs were substantially higher in patients who required hospitalisation during the acute phase of COVID-19 and in older adults. Excess in hospitalisations, primary care physicians and medical specialists' visits-related costs were observed. Conclusions Long-term effects of SARS-CoV-2 infections translate into excess healthcare costs, months after recovery, hence requiring adjustments of funds allocation. These excess costs gradually diminish after recoveree, returning to baseline differences 16 months after recoveree.
AB - Introduction Postacute sequelae resulting from SARS-CoV-2 infections (LONG-COVID) have been reported. The resulting added economic burden from the perspective of healthcare organisations is not clear. Therefore, this study aims to evaluate the additive healthcare costs among COVID-19 recoverees, in a large community-dwelling general population, as incurred by an insurer-provider organisation over time. Methods In this historical cohort study, cost data from Clalit Health Services (CHS) were analysed. The primary endpoint was the direct cost incurred by CHS per month per person. Costs were measured for COVID-19 recoverees and matched controls, from January 2019 to January 2022. Difference in differences (DiDs) were calculated as the difference in mean monthly costs in cases and controls in the post-COVID-19 individual period, deducing their cost difference in a prepandemic 12 months baseline period. Results Among N=642 868 community-dwelling COVID-19 recoverees, 268 948 (40.8%) were 0-19 years old and 63 051 (9.6%) were 60 years or older. A total of 16 017 (2.5%) of recoverees had been hospitalised during the acute phase of the COVID-19 disease. Costs in cases and controls converged after 16 months from recovery. The mean monthly cost incurred by CHS per COVID-19 recoverees over up to 15 months (mean: 8.25) of post-COVID-19 follow-up was higher by 8.2% (US$8.2) compared with matched controls. The excess cost attributable to post-COVID-19 effects (DID) was 7.6% of the cost in controls (US$7.7 per patient per month). Both net and relative DIDs were substantially higher in patients who required hospitalisation during the acute phase of COVID-19 and in older adults. Excess in hospitalisations, primary care physicians and medical specialists' visits-related costs were observed. Conclusions Long-term effects of SARS-CoV-2 infections translate into excess healthcare costs, months after recovery, hence requiring adjustments of funds allocation. These excess costs gradually diminish after recoveree, returning to baseline differences 16 months after recoveree.
KW - COVID-19
KW - health economics
KW - health services research
UR - http://www.scopus.com/inward/record.url?scp=85166181275&partnerID=8YFLogxK
U2 - 10.1136/bmjgh-2023-012588
DO - 10.1136/bmjgh-2023-012588
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C2 - 37463787
AN - SCOPUS:85166181275
SN - 2059-7908
VL - 8
JO - BMJ Global Health
JF - BMJ Global Health
IS - 7
M1 - 012588
ER -