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 up most 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.

Which patients bring the most costs for hospital? A study on the cost determinants among COVID-19 patients in Iran

“…Our study showed that diabetes was not related to the median of hospitalization costs in both groups that is opposite to Ohsfeldt et al study [ 15 ]. Regarding other comorbidities, suffering from cardiovascular disease as a risk factor for the disease severity and death [ 13 ] increased the median cost in both groups that is in line to another study in Iran [ 8 ].…”

“…Disease severity and prolonged hospitalization could be related with higher cost in patients. Studies have shown that the hospitalization costs in the COVID-19 patients are different based on different characteristics across countries [ 2 , 7 , 8 ]. Planning for and forecasting the future needs to the financial support especially for the fragile population could empower countries in the management and control of the future crisis caused by the next wave of COVID-19 pandemic [ 9 , 10 ].…”

“…Understanding the most important cost components of the COVID-19 pandemic and analysis of its determinants could enable targeted policy making in combating the next crisis. There are few studies examined the cost composition of COVID-19 patients and its determinants especially in Iran [ 2 , 8 , 12 ]. So the present study aimed to investigate driving factors of direct hospitalization cost of COVID-19 patients in Hamadan city.…”

Costs of inpatient care and out-of-pocket payments for COVID-19 patients: A systematic review

“…For instance, studies from Kenia and Myanmar have used market prices to report costs [ 15 , 35 ]. Studies from Saudi Arabia and Iran, on the other hand, have used medical tariffs to report costs, and a study from Ethiopia has used medical documents in public health centers to report diagnostic costs [ 24 , 27 , 40 ].…”

“…Data on costs are presented as mean per patient, except for HajiAghajani et al (2022), presented as median cost per patient.…”