Economic Burden of Hospitalized COVID-19 Patients in Iran

Abstract

Background: The outbreak of COVID -19 has had destructive influences on social and economic systems as well as many aspects of human life. In this study, we aimed to estimate the economic effects of COVID-19 at the individual and societal levels during a fiscal year.Methods: This is an economic evaluation study conducted as cross-sectional. Data of the COVID-19 patients referred to the hospitals affiliated to Bushehr University of Medical Sciences between March 2020 and 2021 were collected through the hospital information system (HIS). Cost of illness analysis was used to estimate the economic burden of COVID-19 for the province and Iran. The study methodology was based upon the human capital approach and bottom-up technic. Results: The COVID -19 pandemic has resulted in 9711 confirmed hospital cases and 767 deaths in Bushehr province during the study period. The direct medical costs were estimated to be 439,774,265,491 Rials ($ 27,893,839) in total with mean cost of 45,286,198 Rials ($ 2872) per patient. Hospitalization, drugs and ICU costs were the highest with 36.44, 30.80 and 26.88% of total direct costs respectively. Indirect costs, including income loss due to hospitalization, recovery period at home and premature death were 20,884,492,800 ($ 1,324,654), 62,058,707,200 ($ 3,936,237) and 854,181,793,653 ($ 54,178,726) Rials. Finally economic burden for the province and country was estimated to be 1,376,899,259,144 Rials ($ 87,333,455) and 83,957,271,899,024 Rials ($ 5,325,210,700).Conclusion: The results showed that the economic burden of this disease particularly premature deaths costs is remarkably high. In addition, direct costs could go beyond the health system capacity. Therefore, in order to increase the resiliency of the health system and the stability in services delivery, preventive-oriented strategies have to be more seriously considered by policymakers.

Custos hospitalares relacionados ao tratamento de pacientes com COVID-19 e o impacto de fatores clínicos e demográficos.

“…O custo médio por internação hospitalar em 11 estudos levantados (32,(65)(66)(67)(68)(69)(70)(71)(72)(73)(74) variou entre US$ 1.178 (69) e US$ 12.916 (73) . O resultado obtido em nosso estudo (US$ 12.637,42) (67,68,73) .…”

“…Este resultado pode ser decorrente da existência de protocolos de instituição de cuidados paliativos de forma estruturada, evitando a instituição de medidas fúteis para pacientes com baixa expectativa de sobrevida (80) . Em onze dos estudos disponíveis os principais componentes de custo foram descritos (33,66,67,(69)(70)(71)(72)74,75,81,82) , sendo que em 5 deles (33,66,67,81,82) o custo com o RH foi o componente mais representativo, variando de 37% (33,67) a 84,81% (67) do custo total, o que condiz com os resultados obtidos em nosso estudo, em que os custos com RH representaram a maior parte dos custos em todos os setores hospitalares (acima de 80%). A estimativa mais acurada da proporção do custo com RH está no estudo brasileiro de Cardoso et al (66) , que utilizou a metodologia de custeio baseado em atividade e tempo.…”