Healthcare Resource Utilization and Costs Associated with COVID-19 in Colombia: A Retrospective Database Study

OBJECTIVES: To describe the Healthcare Resource Utilization (HCRU) and costs related to the management of COVID-19 in one of the largest Health Maintenance Organization (HMO) in Colombia.

METHODS: This is a retrospective observational study in patients diagnosed with COVID-19 who received medical care at the HMO -Sura- in Colombia between March 2020, and January 2023. A micro costing method was used based on available data on hospital stay (general ward and Intensive Care Unit [ICU]), outpatient, emergency visits, medications, consumables, laboratories, diagnostic imaging, and most frequent procedures. and costs estimations were obtained from the technical note of the sufficiency study and SISMED database. All costs were adjusted to 2023 and converted to US dollars. Disease severity was defined based on the outpatient and inpatient services utilization.

RESULTS: 1,030,037 cases of positive COVID-19 were observed during the study period. Most cases (80%) were mild (n=815,936) or moderate (n=7,804) outpatient care), followed by sever (n= 197,348 , 19.2%) and critical cases (n= 8,949, 0.9%). For hospitalized cases, the median length of stay (LoS) was 5 days (Interquartile Range [IQR] 5 days) for hospitalization in general ward and 13 days (IQR 10 days) for ICU. The median cost for mild to moderate cases treated at the outpatient setting ranged between 64 USD (IQR 20.3 USD) to 113.3 USD (IQR 34 USD). For severe (hospitalized patients on general ward) and critical cases (ICU patients), the median cost was 4,187.2 USD (IQR 1,693.8 USD) and 29,676.0 USD (IQR 22,095.6 USD) respectively.

CONCLUSIONS: Most COVID patients were treated only in an outpatient setting mirroring low-cost expenses. However, for severe and critical COVID cases the total healthcare costs were substantially higher due to the LoS in general ward and ICU.