Risk factors, health outcomes, healthcare services utilization, and direct medical costs of long COVID patient 2022 Tene et al

[Andy]

Abstract

Background
Data on the economic burden of long-COVID are scarce. We aimed to examine the prevalence and medical-costs for treating long-COVID.

Methods
We conducted this historical-cohort study using data of patients with COVID-19 among members of a large health-provider in Israel. Cases were defined according to physician diagnosis (definite long-COVID) or suggestive symptoms given ≥4-weeks from infection (probable cases). Healthcare resource utilization (HCRU) and direct healthcare costs (HCCs) in the period prior to infection and afterwards were compared across study groups.

Findings
Between March 2020, and March 2021, a total of 180,759 COVID-19 patients (mean[SD] age=32.9y [19.0y]; 89,665 [49.6%] females) were identified. Overall, 14,088(7.8%) individuals developed long-COVID (mean[SD] age=40.0y [19.0y]; 52.4% females). Among them, 1,477(10.5%) were definite long-COVID and 12,611(89.5%) were defined as probable long-COVID.

Long-COVID was associated with age (AOR=1.058 per year, 95%CI:1.053-1.063), female sex (AOR=1.138;1.098-1.180), smoking (AOR=1.532;1.358-1.727), and symptomatic acute-phase (AOR=1.178;1.133-1.224), primarily muscle-pain and cough. Hypertension was an important risk factor for long-COVID among younger adults. Compared to non-long-COVID patients, definite and probable cases were associated with AORs of 2.47(2.22-2.75) and 1.76(1.68-1.84) for post-COVID hospitalization, respectively. While among non-long COVID patients HCCs decreased from US$ 1400 during 4 months before the infection to US$ 1021, among long-COVID patients HCC increased from $US 2435 to $US 2810.

Interpretation
Long-COVID is associated with a substantial increase in healthcare services utilization and direct-medical costs. Our findings underline the need for timely planning and allocating resources for long-COVID patient-centered care as well as for its secondary-prevention in high-risk patients.

Open access, https://www.ijidonline.com/article/S1201-9712(22)00640-3/

 

[rvallee]

We collected all healthcare resource utilization (HCRU) and hospitalizations during a one-year period prior to infection and one-year afterwards

At best that would capture maybe 10% of the total costs, if at that. The vast majority of patients have little to no interaction with healthcare. This is far more the cost of severe COVID than Long Covid.

Both HCRU and HCC models were stratified according to HCRU subtypes: (a) hospitalization including general hospitalization and elective procedures, (b) home-hospitalization (including home visits of all medical professional and medical equipment rent fees), (c) visits to emergency departments or after-hour emergency clinics, (d) visits to outpatient clinics, (e) laboratory tests and imaging, and (f) dispensed prescription drugs and medical equipment.

In most cases, the only expenses are tests and labor. So those costs are high despite a high level of negligence since most patients receive no actual medical care.

HCC was calculated only if the patient had complete relevant follow-up duration for both pre- and post-PCR test. To avoid dealing with zero inflation, 1$ was added in case of zero cost.

So anyone without a PCR confirmation doesn't get counted, which is also most, and must have been followed-up, which most physicians refuse to .

So this is a calculation based on a small fraction of a fraction. And none of it accounts for indirect costs, which are far higher, and direct losses, especially in the form of lost wages. The true direct costs are hidden, and the indirect costs even more. This is the kind of accounting that would lead anyone to lose their job, but using externalities to hide negligence and failure is usually a safe bet, as it's other people who have to count and they usually don't.

And by their own admission, healthcare services are so negligent that they can't rely on their records, which is true:

Our study had some limitations. Similar to the UK(Subramanian, Nirantharakumar et al. 2022), the proportion of patients with a physician diagnosed long COVID is relatively small. Therefore, we had to identify patients by COVID-related symptoms given more than four weeks from the first positive PCR test.

By not recording most of it, it's perceived not to exist. Even though it does. In most circumstances this is simply called a big lie. Same old same old in medicine, the system barely works by being massively negligent of most health issues.