アブストラクト | OBJECTIVES: To quantify direct costs and healthcare resource utilisation (HCRU) associated with acute COVID-19 in adults in England. DESIGN: Population-based retrospective cohort study using Clinical Practice Research Datalink Aurum primary care electronic medical records linked to Hospital Episode Statistics secondary care administrative data. SETTING: Patients registered to primary care practices in England. POPULATION: 1 706 368 adults with a positive SARS-CoV-2 PCR or antigen test from August 2020 to January 2022 were included; 13 105 within the hospitalised cohort indexed between August 2020 and March 2021, and 1 693 263 within the primary care cohort indexed between August 2020 and January 2022. Patients with a COVID-19-related hospitalisation within 84 days of a positive test were included in the hospitalised cohort. MAIN OUTCOME MEASURES: Primary and secondary care HCRU and associated costs </=4 weeks following positive COVID-19 test, stratified by age group, risk of severe COVID-19 and immunocompromised status. RESULTS: Among the hospitalised cohort, average length of stay, including critical care stays, was longer in older adults. Median healthcare cost per hospitalisation was higher in those aged 75-84 ( pound8942) and >/=85 years ( pound8835) than in those aged <50 years ( pound7703). While few (6.0%) patients in critical care required mechanical ventilation, its use was higher in older adults (50-74 years: 8.3%; <50 years: 4.3%). HCRU and associated costs were often greater in those at higher risk of severe COVID-19 than in the overall cohort, although minimal differences in HCRU were found across the three different high-risk definitions. Among the primary care cohort, general practitioner or nurse consultations were more frequent among older adults and the immunocompromised. CONCLUSIONS: COVID-19-related hospitalisations in older adults, particularly critical care stays, were the primary drivers of high COVID-19 resource use in England. These findings may inform health policy decisions and resource allocation in the prevention and management of COVID-19. |
ジャーナル名 | BMJ open |
投稿日 | 2023/12/29 |
投稿者 | Yang, Jingyan; Andersen, Kathleen Michelle; Rai, Kiran K; Tritton, Theo; Mugwagwa, Tendai; Reimbaeva, Maya; Tsang, Carmen; McGrath, Leah J; Payne, Poppy; Backhouse, Bethany Emma; Mendes, Diana; Butfield, Rebecca; Naicker, Kevin; Araghi, Mary; Wood, Robert; Nguyen, Jennifer L |
組織名 | Pfizer Inc, New York, New York, USA jingyan.yang@pfizer.com.;The Institute for Social and Economic Research and Policy, Columbia University,;New York, New York, USA.;Pfizer Inc, New York, New York, USA.;Adelphi Real World, Bollington, UK.;Pfizer, Tadworth, UK. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38154885/ |