ORIGINAL RESEARCH
Tamkeen Khan, PhD; Stavros Tsipas, MA; Gregory D. Wozniak, PhD; Kate Kirley, MD; Arch G. Mainous III, PhD
Corresponding Author: Tamkeen Khan, PhD; American Medical Association
Email: Tamkeen.Khan@ama-assn.org
DOI: 10.3122/jabfm.2023.230069R1
Keywords: COVID-19, Health Care Economics, Health Expenditures, Hospitalization, Pandemics, Propensity Score, Vaccination
Dates: Submitted: 02-25-2023; Revised: 06-23-2023; Accepted: 07-05-2023
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BACKGROUND: Post-acute sequelae of coronavirus (PASC) disease of 2019 (COVID-19) include morbidity and mortality, but little is known of the impact on medical expenditures. This study measures patients’ healthcare costs following COVID hospitalization prior to vaccinations.
METHODS: The MerativeTM MarketScan® database is used to track trends in medical expenditures for commercially insured patients hospitalized for COVID-19 (case subjects) compared to COVID-19 patients not hospitalized (control subjects) using a propensity score matching model. Medical expenditures were estimated from 30-, 60-, and 120-day clean periods after an initial COVID-19 encounter through the end of 2020.
RESULTS: Average total medical expenditures were 96% higher for individuals hospitalized for COVID-19 starting 30 days after initial COVID-19 encounter and almost 70% higher 120 days after based on the propensity score matching. The average spending differential was $11,242 30 days after and $4,959 120 days after. This effect is highest for inpatient admissions and services 60 days after at $56,862 and lowest among pharmaceuticals 120 days after at $329. The magnitude of the difference is greater for those with hypertension or diabetes where total expenditures is $14,958 30 days after, and $5,962 120 days after compared to those without these chronic conditions.
DISCUSSION: The results suggest both health and economic implications for COVID-19 hospitalization and supports the use of vaccinations to help mitigate these implications. PASC include increased healthcare costs for hospitalized patients, particularly for those with chronic conditions. Preventing COVID-19 hospitalization has economic value in terms of reduced medical spending in addition to health benefits associated with reduced morbidity and mortality.