TREATMENT COSTS FOR COVID-19 PATIENTS IN A TERTIARY HOSPITAL FROM SERBIA

  1. Predrag S. Sazdanovic
  2. Slobodan Milisavljevic
  3. Dragan R. Milovanovic
  4. Slobodan M. Jankovic
  5. Dejan Baskic
  6. Dragana Ignjatovic Ristic
  7. Dejana Ruzic Zecevic
  8. Aleksandra Tomic Lucic
  9. Natasa Djordjevic
  10. Danijela Jovanovic
  11. Andjelka Stojkovic
  12. Tatjana Lazarevic
  13. Milica Begovic Cvetkovic
  14. Marina J. Kostic

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Abstract

Introduction

Aim of our study was to identify total costs of COVID-19 inpatients treatment in an upper-middle income country from Southeast Europe.

Methods

This retrospective, observational cost of illness study was performed from National Health Insurance Fund perspective and included a cohort of 118 males and 78 females admitted to COVID-19 ward units of a tertiary center, during the first wave of epidemics.

Results

The median of total costs in the non-survivors’ subgroup (n=43) was 3279.16 Euro (4023.34, 355.20, 9909.61) which is higher than in the survivors (n=153) subgroup 747.10 Euro (1088.21, 46.71, 3265.91). The odds ratio of Charlson Comorbidity Index total score and every 100-Euros increase of patient’s total hospital treatment costs for fatal outcome were 1.804 (95% confidence interval 1.408-2.311, p<0.001) and 1.050 (1.029-1.072, p<0.001), respectively.

Conclusions

Direct medical treatment costs for COVID-19 inpatients represent significant economic burden. The link between increased costs and unfavorable final outcome should be further explored.

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    SciScore for 10.1101/2021.11.30.21267085: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIACUC: The study was approved by the Institutional Ethics Committee and conducted according to principles of Declaration of Helsinki (Decision of the Ethics Committee number 01/20-407, dated April 3rd 2020).
    IRB: The study was approved by the Institutional Ethics Committee and conducted according to principles of Declaration of Helsinki (Decision of the Ethics Committee number 01/20-407, dated April 3rd 2020).
    Sex as a biological variableThe sample was based on observational approach and it included a cohort of 196 adult patients (males and females, 18 years and older) admitted to COVID-19 ward units of University Clinical Center “Kragujevac”, Kragujevac, Serbia, between March 14th and April 26th, 2020, during the first wave of epidemics.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Several limitations of our study exist such as, the single-center scope, the shortcomings of observational design with retrospective data collection, and the absence of adjustment of study outcomes for some important factors (e.g. COVID-19 complications, prescription drugs, care within intensive care units). We analyzed direct costs for patients’ medical treatment only, and we did not take into consideration the effects of indirect factors on overall cost burden for hospital economic performances, such as implementation of infection control measures or changes of working productivity of hospital personnel due to the psychological stress (19, 20). In general, the logistic reasons (e.g. technical constraints of hospital database, managerial obstacles) precluded more comprehensive methodological approach in our study. On the other side, we believe that health economic researchers have to account one circumstance of particular interest - a study time-frame within the dynamics of epidemic course. The evidences are accumulating that changing of SARS-CoV-2 biology and pattern of COVID-19 disease, as well as improvement of preventive, diagnostic and treatment measures, significantly affect many individual and societal outcomes related to the pandemics. For example, the in-hospital case-fatality rate from COVID-19 in United States decreased from 22.1% at the beginnings of epidemics (similar to our results), to 6.5% after several months (21). In the meantime, treatment guidelines incor...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

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  2. Version published to 10.1101/2021.11.30.21267085v1 on medRxiv