In-hospital Economic Burden for COVID-19 Infection Using Step-Down Cost Accounting: A Case from Central Iran

Abstract

Background: The novel coronavirus disease 2019 (COVID-19) has placed heavy direct and indirect economic burden on the people and the health system. Objectives: The present study aimed to estimate the economic burden of COVID-19 in Qom Province, using the step-down cost accounting (SDCA) method. Methods: This descriptive, cross-sectional study included all COVID-19 patients in Qom Province from February 19, 2020, to June 19, 2020. The patients’ data were collected in the form of major cost groups with integrated health system (IHS), health information system (HIS), and a financial software called Roozamad. The governmental, out-of-pocket, and opportunity costs paid by patients and hospitals were calculated and evaluated using SDCA in Microsoft Excel software. Results: The incidence of COVID-19 infection was 518 per 100,000 populations in Qom Province in the aforementioned period. The total government costs for the treatment of the patients were calculated to be 2,229,216,930,370 Rials (8,916,867 $). Among the major governmental cost groups, personnel costs accounted for the highest total expenditures. In addition, out-of-pocket costs of patients and their families equaled 30,038,013,060 Rials (120,152 $). The costs of final service departments accounted for more than half of the total costs. The opportunity costs were calculated as 420 billion Rials (15.68% of total costs). Conclusions: According to the findings, the direct and indirect costs associated with the treatment of COVID-19 patients can impose a heavy economic burden on the households and health care system. Therefore, disease prevention strategies such as observing health protocols are recommended to reduce the burden of the disease.

Costs of inpatient care and out-of-pocket payments for COVID-19 patients: A systematic review

“…After removing the duplicates and screening for relevant titles/abstracts, 49 papers were reviewed to select eligible studies. Finally, 31 studies met the eligibility criteria and were included in the review [ 10 – 13 , 15 , 16 , 20 – 29 , 31 – 45 ]. The full information on the study selection process is shown in Fig 1 .…”

“…In the studies that reported the average total cost and the percentage of each cost component from the total cost, the average cost per person for each cost component was calculated and reported [ 10 , 26 – 28 ]. In studies where the total cost was reported for all patients, the cost per person was calculated using the number of people who used the service [ 29 ]. Also, the information on patient/day and the number of patients are used to calculate the cost per person.…”

“…and reported [10,[26][27][28]. In studies where the total cost was reported for all patients, the cost per person was calculated using the number of people who used the service [29]. Also, the information on patient/day and the number of patients are used to calculate the cost per person.…”