Quantifying all-cause healthcare resource utilization and costs of children with mild-to-moderate long COVID in France
Jingyan Yang; Cheikh Tamberou; Elise Arnee; Pierre-Alexandre Squara; Ayoub Boukhlal; Jennifer L. Nguyen; Hannah R. Volkman; Stephane Fievez; Marina Lepoutre-Bourguet; Haifa Ben Romdhane; Charlotte Renaudat; Pascal Crépey; Olivier Robineau
BACKGROUND
Although children are known to be at risk of developing long COVID, its economic burden is poorly described in these patients. We aimed to assess the all-cause healthcare resource utilization (HCRU) and associated direct medical costs of children with mild-to-moderate long COVID in France.
METHODS
This retrospective cohort study utilized The Health Improvement Network (THIN) primary care electronic health records (EHRs) to identify children aged <18 years with a confirmed/probable coronavirus disease 2019 (COVID-19) diagnosis during 03/2020-12/2022 who developed long COVID, which was identified per the World Health Organization as suggestive symptoms present ≥3 months following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patient characteristics and all-cause HCRU were summarized, as were direct healthcare costs from a national health insurance perspective. HCRU and costs were stratified into seven areas of care: healthcare encounters, medical procedures, retail pharmacy usage, testing, sick leave, medical transport, and medical device usage.
RESULTS
Of 27,537 children diagnosed with acute COVID-19, 3,888 (14.1%) developed long COVID; mean age was 8.9 years, 49.2% were female and, among those with comorbidity, 24.5% had a Charlson Comorbidity Index (CCI) score ≥1. During a mean follow-up of 12.6 months after their acute COVID-19 diagnosis, 93.6% of children had general practitioner (GP) consultations, 93.5% had pharmacy usage, and 61.0% had medical procedures. Costs were highest during the first year, with per patient per year costs of €823; 4.3% of children required caregiver-related work absenteeism. When compared to children with COVID-19 who did not develop long COVID, a diagnosis of long COVID was associated with an incremental cost increase of €98 per patient per year.
LIMITATIONS
Our findings only represent a national health payer perspective. The true societal burden of long COVID in children is likely underestimated since the indirect costs associated with long COVID are not well captured and access to care varies.
CONCLUSION
Children living with long COVID managed in the community pose a non-neglectable burden on French national health insurance. These findings reinforce the importance of managing long COVID with a multidisciplinary approach and optimizing resource allocation for children.
Link | PDF | Journal of Medical Economics [Open Access]
Jingyan Yang; Cheikh Tamberou; Elise Arnee; Pierre-Alexandre Squara; Ayoub Boukhlal; Jennifer L. Nguyen; Hannah R. Volkman; Stephane Fievez; Marina Lepoutre-Bourguet; Haifa Ben Romdhane; Charlotte Renaudat; Pascal Crépey; Olivier Robineau
BACKGROUND
Although children are known to be at risk of developing long COVID, its economic burden is poorly described in these patients. We aimed to assess the all-cause healthcare resource utilization (HCRU) and associated direct medical costs of children with mild-to-moderate long COVID in France.
METHODS
This retrospective cohort study utilized The Health Improvement Network (THIN) primary care electronic health records (EHRs) to identify children aged <18 years with a confirmed/probable coronavirus disease 2019 (COVID-19) diagnosis during 03/2020-12/2022 who developed long COVID, which was identified per the World Health Organization as suggestive symptoms present ≥3 months following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patient characteristics and all-cause HCRU were summarized, as were direct healthcare costs from a national health insurance perspective. HCRU and costs were stratified into seven areas of care: healthcare encounters, medical procedures, retail pharmacy usage, testing, sick leave, medical transport, and medical device usage.
RESULTS
Of 27,537 children diagnosed with acute COVID-19, 3,888 (14.1%) developed long COVID; mean age was 8.9 years, 49.2% were female and, among those with comorbidity, 24.5% had a Charlson Comorbidity Index (CCI) score ≥1. During a mean follow-up of 12.6 months after their acute COVID-19 diagnosis, 93.6% of children had general practitioner (GP) consultations, 93.5% had pharmacy usage, and 61.0% had medical procedures. Costs were highest during the first year, with per patient per year costs of €823; 4.3% of children required caregiver-related work absenteeism. When compared to children with COVID-19 who did not develop long COVID, a diagnosis of long COVID was associated with an incremental cost increase of €98 per patient per year.
LIMITATIONS
Our findings only represent a national health payer perspective. The true societal burden of long COVID in children is likely underestimated since the indirect costs associated with long COVID are not well captured and access to care varies.
CONCLUSION
Children living with long COVID managed in the community pose a non-neglectable burden on French national health insurance. These findings reinforce the importance of managing long COVID with a multidisciplinary approach and optimizing resource allocation for children.
Link | PDF | Journal of Medical Economics [Open Access]