COVID-19 related hospitalization costs; assessment of influencing factors
Abstract
Objective: Our aim is to assess the effective factors on hospitalization costs of COVID-19 patients. Methods: Data related to clinical characteristics and cost of hospitalized COVID-19 patients from February 2020 until July 2020, in a public teaching hospital in Tehran, Iran was gathered in a retrospective cohort study. The corresponding factors influencing the diagnostic and therapeutic costs were evaluated, using a generalized linear model. Results: The median COVID-19 related diagnostic and therapeutic costs in a public teaching hospital in Iran, for one hospitalized COVID-19 patient was equal to 271.1 US dollars (USD). In patients who were discharged alive from the hospital, the costs increased with patients’ pregnancy (P<0.001), loss of consciousness during hospitalization (P<0.001), a history of drug abuse (P=0.006), history of chronic renal disease (P<0.001), end stage renal disease (P=0.002), history of brain surgery (P=0.001), history of migraine (P=0.001), cardiomegaly (P=0.033) and occurrence of myocardial infarction during hospitalization (P<0.001). In deceased patients, low age P<0.001), history of congenital disease (P=0.024) and development of cardiac dysrhythmias during hospitalization (P=0.044) were related to increase in therapeutic costs. Conclusion: Median diagnostic and therapeutic costs in COVID-19 patients, hospitalized in a public teaching hospital in Iran were 271.1 USD. Hoteling and medications made upmost of the costs. History of cardiovascular disease and new onset episodes of such complications during hospitalization were the most important factors contributing to the increase of therapeutic costs. Moreover, pregnancy, loss of consciousness, and renal diseases are of other independent factors affecting hospitalization costs in COVID-19 patients.
2. Vincent J-L, Creteur J. Ethical aspects of the COVID-19 crisis: how to deal with an overwhelming shortage of acute beds. Eur Heart J Acute Cardiovasc Care. 2020;9(3):248-52.
3. American college of surgeons. COVID-19: Executive orders by state on dental, medical, and surgical procedures 2020 [Available from: https://www.facs.org/covid-19/legislative-regulatory/executive-orders].
4. Kliff S. Hospitals knew how to make money. Then Coronavirus happened.: New York Times; 2020 [Available from:
https://www.nytimes.com/2020/05/15/us/hospitalsrevenue-coronavirus.html].
5. Gupta A, Madhavan MV, Sehgal K, Nair N, Mahajan S, Sehrawat TS, et al. Extrapulmonary manifestations of
COVID-19. NatMed. 2020;26(7):1017-32.
6. Neishaboori AM, Moshrefiaraghi D, Ali KM, Toloui A, Yousefifard M, HosseiniM. Central nervous systemcomplications
in COVID-19 patients; a systematic review and meta-analysis based on current evidence. Arch Acad EmergMed. 2020;8:e62.
7. Toloui A, Moshrefiaraghi D, Neishaboori AM, Safari S, Yousefifard M, Aghajani MH. Cardiac complications and pertaining mortality rate in COVID-19 patients; a systematic review and meta-analysis. Arch Acad Emerg Med. 2021;9:e18.
8. Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li Ym, et al. Comorbidity and its impact on 1590 patients with
Covid-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5):2000547.
9. Azari S, Omidi N, Arabloo J, Pourhosseini H, Rezapour A. Resource utilization and cost of hospitalized patients
with COVID-19 in Iran: rationale and design of a protocol. Adv J EmergMed. 2020;4(2s):e55.
10. Ng VK, Cribbie RA. The gamma generalized linear model, log transformation, and the robust Yuen-Welch test for
analyzing group means with skewed and heteroscedastic data. CommStatist Simulation Comput. 2019;48(8):2269-
86.
11. Ding R, Zhu D, He P, Ma Y, Chen Z, Shi X. Comorbidity in lung cancer patients and its association with medical
service cost and treatment choice in China. BMC Cancer. 2020;20(1):250.
12. Chick J. Alcohol and COVID-19. Alcohol and alcoholism (Oxford, Oxfordshire). 2020.
13. Eskandar EN, AltschulDJ, Ramos RdLG, Cezayirli P, Unda SR, Benton J, et al. Neurologic syndromes predict higher
in-hospital mortality in COVID-19. Neurology. 2021;96(11):e1527-38.
14. Lim S, Bae JH, Kwon H-S, Nauck MA. COVID-19 and diabetes mellitus: from pathophysiology to clinical management.
Nat Rev Endocrinol. 2021;17(1):11-30.
15. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al. Update: characteristics of symptomatic
women of reproductive age with laboratory confirmed SARS-CoV-2 infection by pregnancy status—United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(44):1641-7.
16. Lewnard JA, Liu VX, Jackson ML, Schmidt MA, Jewell BL, Flores JP, et al. Incidence, clinical outcomes, and transmission dynamics of severe coronavirus disease 2019 in California and Washington: prospective cohort study.
BMJ. 2020;369:m1923.
17. Sorouri M, Kasaeian A,Mojtabavi H, Radmard AR, Kolahdoozan S, Anushiravani A, et al. Clinical characteristics,
outcomes, and risk factors for mortality in hospitalized patients with COVID-19 and cancer history: a propensity
score-matched study. Infect Agent Cancer. 2020;15(1):74.
18. Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020;584(7821):430-6.
19. National Institue of Health. Special considerations in pregnancy 2020 [Available from: https://www.covid19treatmentguidelines.nih.gov/specialpopulations/pregnancy/].
20. Luo Y, Yin K. Management of pregnant women infected with COVID-19. Lancet Infect Dis. 2020;20(5):513-4.
21. Khan T, Stecker M, Stecker M. Evaluating the patient with loss of consciousness. Surg Neurol Int. 2015;6(Suppl
6):S262-5.
22. Ellul M, Benjamin L, Singh B, Lant S, Michael B, Kneen R, et al. Neurological associations of COVID-19. Lancet
Neurol. 2020;19(9):767-83.
23. Swiss Society Of Intensive Care Medicine. Recommendations for the admission of patients with COVID-19 to intensive care and intermediate care units (ICUs and IMCUs). Swiss Med Wkly. 2020;150:w20227.
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Issue | Vol 6 No 1 (2022): Winter (February) | |
Section | Original article | |
DOI | 10.18502/fem.v6i1.7675 | |
Keywords | ||
Cardiovascular Diseases COVID-19 Effective Factors Hospitalization Costs |
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