Background: Various studies have drawn similarities between respiratory conditions such as pneumonia and COVID-19. Respiratory disease (e.g., viral pneumonia J12.8) or signs or symptoms of respiratory disease (e.g., shortness of breath R06.0, cough R05) a respiratory disease (e.g., viral pneumonia J12.8) are the most notable symptoms that are associated with COVID-19. Pneumonia is also among the top five most prevalent reasons for admissions in medical schemes and is one of the expensive conditions to treat. This further accounts for a significant portion of hospitalisation expenditure.
Objectives:The primary objective of this study was to study the characteristics of medical scheme patient's viral pneumonia as a primary ICD-10 diagnosis and ICD-10 secondary diagnosis that were admitted into private hospitals.
Methods:The study design was a descriptive analysis of medical schemes admissions data that occurred in 2020. The review period was claims received between March to August 2020. The inclusion criteria were patients viral pneumonia primary ICD-10 code. Patients with a secondary ICD-10 code who had a COVID-19 related diagnosis were patients who had a laboratory-confirmed (RT-PCR assay) COVID-19.
Results:The study covered a total of 53 medical schemes' data. These accounted for 8,3 million lives. The analysis included a total of 3,437 admissions that had a viral pneumonia primary admissions ICD-10 code. Other viral pneumonia accounted for a significant proportion of the admissions; 82 percent. The second-highest group was viral pneumonia, unspecified, which accounted for 16 percent of admissions. Other types of viral pneumonia included respiratory syncytial virus pneumonia, adenoviral pneumonia and parainfluenza virus pneumonia, which accounted for the remaining 2 percent. The paid amount for other viral pneumonia compared to viral pneumonia, unspecified was not statistically significant, (R66 399 vs. R67 490; p = 0.8961). The average inpatient days were also not significantly different (9.3 days vs. 8.7 days p = 0.1679). Other viral pneumonia compared to viral pneumonia, unspecified were likely to have a COVID-19 confirmed secondary ICD-10 diagnosis, 63 percent versus 44 percent, p<0.001. Significantly, less other viral pneumonia compared to viral pneumonia had a suspected COVID-19 secondary ICD-10 admissions diagnosis, 2 percent vs. 18 percent, p<0.001. Lastly, significantly more other viral pneumonia compared to viral pneumonia had essential primary hypertension COVID-19 secondary ICD-10 admissions diagnoses, 5 percent vs. 2 percent, p<0.001.
Conclusion:The study found that mainly the other viral pneumonia and the viral pneumonia, unspecified primary ICD-10 diagnoses were more likely to be admitted into hospitals. The study found that other viral pneumonia had a higher likelihood than viral pneumonia, unspecified to have a COVID-19 secondary ICD-10 admission diagnosis and were more likely to be associated with a COVID-19 admissions diagnosis. The World Health Organisation (WHO) warns that vaccines against p...