Increased Costs, Utilization Associated With Long-Haul COVID-19

An increase in costs and resource utilization was associated with COVID-19 throughout 6 months postdiagnosis, suggesting a prolonged burden on the health care system. Researchers published their findings in BMC Health Services Research.

“There is extensive evidence that COVID-19 leads to functional decline and that symptoms related to either mild or critical COVID-19 hospitalizations can persist for 60 days or longer,” researchers said, adding that gaining a better understanding of long-term outcomes "is of major public health importance.”

Using claims data from the COVID-19 Research Database, investigators conducted a population-based retrospective cohort study. Patients were included if they had COVID-19 between March 2020 and September 2020 and their last recorded claim was not a hospitalization for severe symptoms. Researchers observed costs and utilization from January 2019 through March 2021.

There were 250,514 patients included in the final cohort. On average, participants had a mean total of .4783 (4.0839) monthly visits prediagnosis, compared to 1.2078 (8.4962) visits postdiagnosis. Average total costs also increased from $128.06 (1182.78) to $351.67 (2473.63) following diagnosis.

“COVID-19 diagnosis [was] associated with .7269 (95% CI, 0.7088 to 0.7449 visits; P < .001) more total health care visits and an additional $223.60 (95% CI, 218.34 to 228.85; P < .001) in monthly costs,” researchers found.

Utilization also increased across the following services:

• inpatient visits (0.5319 more visits, 95% CI 0.5158 to 0.5480 visits; P < 0.001);
• emergency care (0.0626 more visits, 95% CI 0.0600 to 0.0653 visits; P < 0.001);
• telemedicine (0.0359 more visits, 95% CI 0.0351 to 0.0367 visits; P < 0.001);
• surgery (0.0179 more visits, 95% CI 0.0170 to 0.0190 visits; P < 0.001); and
• cardiology services (0.0165 more visits, 95% CI 0.0156 to 0.0174 visits; P < 0.001).

Outcomes varied depending on age, authors noted. Patients who were 17 years of age or younger experienced minor excess utilization and costs that only persisted for 5 months. Those aged 18-44 years saw modest increases, and excess was most prevalent in those aged 45-64 years and over 65 years. The greatest long-term increases in costs and utilization occurred in patients aged 45-64, but those aged 65 years and older experienced the greatest short-term increases.

“COVID-19 diagnosis is associated with more health care visits and greater costs with the latter diminishing more gradually than the former over time. Taken together, this implies that the rise in utilization and costs following COVID-19 diagnosis is manifesting in the form of increasingly costly medical encounters,” researchers said.

Study authors concluded COVID-19 was associated with increased costs and health care resource utilization in the 6-month period following a diagnosis, and more long-term research is needed to understand when these outcomes return to their prediagnosis levels.

Reference:
Koumpias AM, Schwartzman D, Fleming O. Long-haul COVID: healthcare utilization and medical expenditures 6 months post-diagnosis. BMC Health Serv Res. 2022;22(1):1010. doi:10.1186/s12913-022-08387-3