Patient Characteristics and Costs Associated With COVID-19–Related Medical Care Among Medicare Fee-for-Service Beneficiaries

Tsai, Yuping; Vogt, Tara M.; Zhou, Fangjun

doi:10.7326/m21-1102

Cited by 60 publications

(54 citation statements)

References 18 publications

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“…A study from Peru has reported high OOPE for COVID-19 hospitalisations and ineffectiveness of health insurance [44]. Studies from USA have found significant OOPE for COVID-19 hospitalisations among the insured [45,46]. Examples of price gouging by private hospitals for COVID-19 care have been found in many countries in Africa [47].…”

Section: Discussionmentioning

confidence: 99%

Catastrophic health expenditure due to hospitalisation for COVID-19 treatment in India: findings from a primary survey

et al. 2022

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Objective The COVID-19 pandemic has caused widespread illness and a significant proportion of the infected required hospitalisation for treatment. People in developing countries like India were vulnerable to high hospitalisation costs. Despite its crucial importance, few primary studies are available on this aspect of the pandemic. This study was aimed at finding out the out of pocket expenditure (OOPE) and incidence of catastrophic expenditure on hospitalisation of persons infected with COVID-19. A primary survey of 492 randomly selected hospitalisations of individuals tested positive for COVID-19 in high-burden districts during August to November 2020 was carried out telephonically in Chhattisgarh state of India. Results Public hospitals accounted for 69% of the hospitalisations for COVID-19 treatment. Mean OOPE per hospitalisation was Indian Rupees (INR) 4871 in public hospitals and INR 169,504 in private hospitals. Around 3% of hospitalisations in public hospitals and 59% in private hospitals resulted in catastrophic expenditure, at a threshold of 40% of non-food annual household expenditure. Enrolment under publicly or privately funded health insurance was not effective in curtailing OOPE. Multivariate analysis showed that utilisation of private hospitals was a key determinant of incurring catastrophic expenditure.

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Section: Discussionmentioning

confidence: 99%

Catastrophic health expenditure due to hospitalisation for COVID-19 treatment in India: findings from a primary survey

et al. 2022

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“…This latter total is comparable to spending for fee-for-service Medicare beneficiaries hospitalized for COVID-19. 15 …”

Section: Discussionmentioning

confidence: 99%

Assessment of Out-of-Pocket Spending for COVID-19 Hospitalizations in the US in 2020

2021

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IMPORTANCEMany insurers waived cost sharing for COVID-19 hospitalizations during 2020. Nonetheless, patients may have been billed if their plans did not implement waivers or if waivers did not capture all hospitalization-related care. Assessment of out-of-pocket spending for COVID-19 hospitalizations in 2020 may show the financial burden that patients may experience if insurers allow waivers to expire, as many chose to do during 2021. OBJECTIVE To estimate out-of-pocket spending for COVID-19 hospitalizations in the US in 2020. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the IQVIA PharMetrics Plus for Academics Database, a national claims database representing 7.7 million privately insured patients and 1.0 million Medicare Advantage patients, regarding COVID-19 hospitalizations for privately insured and Medicare Advantage patients from March to September 2020. MAIN OUTCOMES AND MEASURES Mean total out-of-pocket spending, defined as the sum of out-of-pocket spending for facility services billed by hospitals (eg, accommodation charges) and professional and ancillary services billed by clinicians and ancillary providers (eg, clinician inpatient evaluation and management, ambulance transport).RESULTS Analyses included 4075 hospitalizations; 2091 (51.3%) were for male patients, and the mean (SD) age of patients was 66.8 (14.8) years. Of these hospitalizations, 1377 (33.8%) were for privately insured patients. Out-of-pocket spending for facility services, professional and ancillary services, or both was reported for 981 of 1377 hospitalizations for privately insured patients (71.2%) and 1324 of 2968 hospitalizations for Medicare Advantage patients (49.

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“…In the medical setting, the COVID-19 pandemic had a significant detrimental effect due to an increase in hospital admissions that led to overwhelming of the medical system and insufficient hospital and ICU beds, as well as a lack of sufficient medical personnel and an increase in hospitalization costs [9][10][11]. The incidence of hospital admissions for SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) infection varies among geographic regions, but up to one quarter of patients needed hospital care, and up to 5% required intensive care measures, with older patients having the highest risk [12,13]. The COVID-19 pandemic had a more significant impact on healthcare systems in developing countries.…”

Section: Introductionmentioning

confidence: 99%

ICU-Associated Costs during the Fourth Wave of the COVID-19 Pandemic in a Tertiary Hospital in a Low-Vaccinated Eastern European Country

Popescu

Ştefan

et al. 2022

IJERPH

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The COVID-19 pandemic has been associated with a tremendous financial and social impact. The pressure on healthcare systems worldwide has increased with each pandemic wave. The present study assesses the impact of the COVID-19 pandemic on healthcare-derived costs of critically ill patients during the fourth wave of the COVID-19 pandemic in a tertiary hospital in Romania. We prospectively included patients admitted to a single-centre intensive care unit (ICU) during the fourth wave of the COVID-19 pandemic. Median daily costs were calculated from financial records and divided in three groups: administrative costs, treatment costs and investigation costs. These were then compared to two retrospective cohorts of non-COVID-19 patients admitted to the same ICU during the same time interval in 2020 and 2019. Demographic data and the management of SARS-CoV-2 infection and of associated organ dysfunctions were recorded to identify risk factors for higher costs. Our results show that the COVID-19 pandemic has been associated with a 70.8% increase in total costs compared to previous years. This increase was mainly determined by an increase in medication and medical-device-related costs. We identified the following as risk factors for increased costs: higher degrees of lung involvement, severity of respiratory dysfunction, need for renal replacement therapy and the use of antiviral or immunomodulatory therapy. Costs were higher in patients who had a shorter duration of hospitalization. In conclusion, the COVID-19 pandemic is associated with increased costs for patients, and rapid measures need to be taken to ensure adequate financial support during future pandemic waves, especially in developing countries.

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Patient Characteristics and Costs Associated With COVID-19–Related Medical Care Among Medicare Fee-for-Service Beneficiaries

Cited by 60 publications

References 18 publications

Catastrophic health expenditure due to hospitalisation for COVID-19 treatment in India: findings from a primary survey

Catastrophic health expenditure due to hospitalisation for COVID-19 treatment in India: findings from a primary survey

Assessment of Out-of-Pocket Spending for COVID-19 Hospitalizations in the US in 2020

ICU-Associated Costs during the Fourth Wave of the COVID-19 Pandemic in a Tertiary Hospital in a Low-Vaccinated Eastern European Country

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