Health Care Resource Utilization and Costs Associated With COVID-19 Among Pediatrics Managed in the Community or Hospital Setting in England: A Population-based Cohort Study

Abstract

Background: Although COVID-19 morbidity is significantly lower in pediatrics than in adults, the risk of severe COVID-19 may still pose substantial health care resource burden. This study aimed to describe health care resource utilization (HCRU) and costs associated with COVID-19 in pediatrics 1–17 years old in England. Methods: A population-based retrospective cohort study of pediatrics with COVID-19 using Clinical Practice Research Datalink (CPRD Aurum) primary care data and, where available, linked Hospital Episode Statistics Admitted Patient Care secondary care data. HCRU and associated costs to the National Health Service were stratified by age, risk of severe COVID-19 and immunocompromised status, separately for those with and without hospitalization records (hospitalized cohort: COVID-19 diagnosis August 2020–March 2021; primary care cohort: COVID-19 diagnosis August 2020–January 2022). Results: This study included 564,644 patients in the primary care cohort and 60 in the hospitalized cohort. Primary care consultations were more common in those 1–4 years of age (face-to-face: 4.3%; telephone: 6.0%) compared with those 5–11 (2.0%; 2.1%) and 12–17 years of age (2.2%; 2.5%). In the hospitalized cohort, mean (SD) length of stay was longer [5.0 (5.8) days] among those 12–17 years old (n = 24) than those 1–4 [n = 15; 1.8 (0.9) days] and 5–11 years old [n = 21; 2.8 (2.1) days]. Conclusions: Most pediatrics diagnosed with COVID-19 were managed in the community. However, hospitalizations were an important driver of HCRU and costs, particularly for those 12–17 years old. Our results may help optimize the management and resource allocation of COVID-19 in this population.