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COVID-19-related hospital cost-outcome analysis: The impact of clinical and demographic factors.
Miethke-Morais, Anna; Cassenote, Alex; Piva, Heloisa; Tokunaga, Eric; Cobello, Vilson; Rodrigues Gonçalves, Fabio Augusto; Dos Santos Lobo, Renata; Trindade, Evelinda; Carneiro D Albuquerque, Luiz Augusto; Haddad, Luciana.
  • Miethke-Morais A; Clinical Director´s Office, Hospital das Clínicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
  • Cassenote A; Department of Gastroenterology, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil; Santa Marcelina Faculty, Discipline of Labour Market and Physician's Health, São Paulo, SP, Brazil; Medical Demography Study Group, Department of Preventive Medicine, Faculty of Medicine FMUSP,
  • Piva H; Executive Director´s Office, Instituto Central, Hospital das Clínicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
  • Tokunaga E; Strategy and Operations Department, Hospital das Clínicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
  • Cobello V; Information Technology Department, Hospital das Clínicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
  • Rodrigues Gonçalves FA; Health Technology Assessment Center, Hospital das Clínicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil; Central Laboratory Division, Instituto Central, Hospital das Clínicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
  • Dos Santos Lobo R; Laboratory of Medical Investigation in Pathogenesis and Targeted Therapy in Onco-Immuno-Hematology (LIM-31), Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil.
  • Trindade E; São Paulo State Health Technology Assessment Network, REPATS-SES/SP, São Paulo State Health Secretariat, SP, Brazil; Hospital das Clínicas HCFMUSP, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
  • Carneiro D Albuquerque LA; Department of Gastroenterology, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil; Gastroenterology Department, Digestive Organs Transplant Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil.
  • Haddad L; Department of Gastroenterology, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil; Gastroenterology Department, Digestive Organs Transplant Division, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil. Electronic address: luciana.haddad@hc.fm.usp.br.
Braz J Infect Dis ; 25(4): 101609, 2021.
Article in English | MEDLINE | ID: covidwho-1363890
ABSTRACT

INTRODUCTION:

Although patients' clinical conditions have been shown to be associated with coronavirus disease (COVID-19) severity and outcome, their impact on hospital costs are not known. This economic evaluation of COVID-19 admissions aimed to assess direct and fixed hospital costs and describe their particularities in different clinical and demographic conditions and outcomes in the largest public hospital in Latin America, located in São Paulo, Brazil, where a whole institute was exclusively dedicated to COVID-19 patients in response to the pandemic.

METHODS:

This is a partial economic evaluation performed from the hospital´s perspective and is a prospective, observational cohort study to assess hospitalization costs of suspected and confirmed COVID-19 patients admitted between March 30 and June 30, 2020, to Hospital das Clínicas of the University of São Paulo Medical School (HCFMUSP) and followed until discharge, death, or external transfer. Micro- and macro-costing methodologies were used to describe and analyze the total cost associated with each patient's underlying medical conditions, itinerary and outcomes as well as the cost components of different hospital sectors.

RESULTS:

The average cost of the 3254 admissions (51.7% of which involved intensive care unit stays) was US$12,637.42. The overhead cost was its main component. Sex, age and underlying hypertension (US$14,746.77), diabetes (US$15,002.12), obesity (US$18,941.55), chronic renal failure (US$15,377.84), and rheumatic (US$17,764.61), hematologic (US$15,908.25) and neurologic (US$15,257.95) diseases were associated with higher costs. Age strata >69 years, reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19, comorbidities, use of mechanical ventilation or dialysis, surgery and outcomes remained associated with higher costs.

CONCLUSION:

Knowledge of COVID-19 hospital costs can aid in the development of a comprehensive approach for decision-making and planning for future risk management.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hospital Costs / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Humans Country/Region as subject: South America / Brazil Language: English Journal: Braz J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: J.bjid.2021.101609

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Hospital Costs / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Humans Country/Region as subject: South America / Brazil Language: English Journal: Braz J Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: J.bjid.2021.101609