Healthcare Resource Utilization and Cost in Patients with Inpatient Mortality Due to COVID-19 Infection
Author(s)
Holy C1, Shah S2, Elangovanraaj N2, Krishnan D3, Gupta S4, Trivedi P2, Devulapally M2, Sakthivel M2, Johnston S5, Mohapatra A2, Coplan P6
1Johnson & Johnson, Somerville, MA, USA, 2Mu Sigma, Bangalore, KA, India, 3Mu Sigma, Bengaluru, KA, India, 4Mu Sigma, Bangalore, India, 5Johnson & Johnson, Annapolis, MD, USA, 6Johnson & Johnson, New Brunswick, NJ, USA
OBJECTIVES: Patients with severe SARS-CoV-2 infection require significant hospital resources. However, since the disease was first identified, treatments have evolved rapidly, reducing fatality rates. This study was designed to evaluate changes in healthcare utilization and cost in patients with in-hospital mortality, from earliest time of disease identification to May 2020. METHODS: Patients from the Premier Healthcare Database with an inpatient event during which patients deceased, with COVID-19 related symptoms and a DRG (diagnostic related group) of respiratory infection or sepsis and, from April 2020 onwards, a COVID-19 diagnosis, were identified, from September 2019 to most recent. Comorbidities and symptoms of COVID-19 and related treatments were used as model variables. Patients with and without COVID-19 diagnosis were matched using propensity score matching (model: logit, method: nearest neighbor, caliper: 0.1). Cost of hospital admission was analyzed using a generalized linear model (family: Gamma, link: log). Least mean square methods were used to evaluate changes in cost over time. RESULTS: Hospital costs averaged $24,899 (95%CI: 21,980-28,205). Length of stay (LOS) increased non-significantly from 8.7 days (95%CI: 8.0-9.5) in December to 10.6 days (95%CI: 9.28-12.18) in May 2020. Comorbidities did not significantly affect patient costs and were therefore not predictors for higher costs. Age category (> 84) was associated with lower cost (mean: 17,350 (95%CI: 15,706-19,166) compared to all other age groups. Hospital costs showed a non-significant trend of decline from December 2019 (mean: $24,860, 95%CI: $21,659-$28,534) to May 2020 (mean: $23,328, 95%CI: $18,269-$29,787). CONCLUSIONS: The COVID-19 epidemic has prompted unprecedented medical research and fast-paced learnings. Our study focused on inpatient fatalities, as these represent the potentially most severe and complex cases. In this population, patient comorbidities did not affect cost. Older age was associated with lower cost. Trends of cost decline and LOS increase were observed over time, suggesting more efficient care and potentially longer survival.
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PIN17
Topic
Economic Evaluation
Disease
Infectious Disease (non-vaccine)