The cost of primary care consultations associated with long COVID in non-hospitalised adults: a retrospective cohort study... 2023 Tufts et al

Abstract

Background
The economic impact of managing long COVID in primary care is unknown. We estimated the costs of primary care consultations associated with long COVID and explored the relationship between risk factors and costs.

Methods
Data were obtained on non-hospitalised adults from the Clinical Practice Research Datalink Aurum primary care database. We used propensity score matching with an incremental cost method to estimate additional primary care consultation costs associated with long COVID (12 weeks after COVID-19) at an individual and UK national level. We applied multivariable regression models to estimate the association between risk factors and consultations costs beyond 12 weeks from acute COVID-19.

Results
Based on an analysis of 472,173 patients with COVID-19 and 472,173 unexposed individuals, the annual incremental cost of primary care consultations associated with long COVID was £2.44 per patient and £23,382,452 at the national level. Among patients with COVID-19, a long COVID diagnosis and reporting of longer-term symptoms were associated with a 43% and 44% increase in primary care consultation costs respectively, compared to patients without long COVID symptoms. Older age, female sex, obesity, being from a white ethnic group, comorbidities and prior consultation frequency were all associated with increased primary care consultation costs.

Conclusions
The costs of primary care consultations associated with long COVID in non-hospitalised adults are substantial. Costs are significantly higher among those diagnosed with long COVID, those with long COVID symptoms, older adults, females, and those with obesity and comorbidities.

Open access, https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02196-1

 

How much is a normal 'annual incremental cost' - if instead of using an average of 'all consultations' it is one that excludes those who might just have one visit for their blood pressure or a sore throat (I don't know what the 'cheaper' ones are but I imagine any 'new illness' is a more appropriate control vs 'all' given 'new' takes 'work-up')?

Or is it substantial because of the numbers of people with long covid?

 

Most consults are just a few minutes of time wasted for both patient and clinician, which will continue as long as they refuse to acknowledge reality. Most consults probably cannot be coded properly to do a full accounting, are more likely to have zero mention of Long Covid. So increased costs with nothing to show for it, and it's a massive undercount.