Comparative Analysis of Service Costs In Intensive Care Unit, Length of Stay and Mortality Rate Before and During the COVID 19 Pandemic

Objective: The aim of the present study was to compare the average length of stay, mortality rates and service costs in intensive care unit provided to patients during October-November-December 2019 (pre-pandemic), with the average length of stay, mortality rates and service costs in intensive care unit during October-November-December 2020 (pandemic). Methods: This was a retrospective cross-sectional comparative, single-center study. The demographic data (age, gender), average length of stay, mortality and hospital costs of intensive care patients during October-November-December 2019 (pre-pandemic) were compared using the hospital records with the same data of patients in the same intensive care unit during October-November-December 2020 (pandemic), and the factors affecting the cost were investigated. Results: Of the 437 patients included in the study, 233 were hospiṫ aliż ed in pre-pandemic period and 204 in pandemic period. Pre-pandemic period mean age was 65.04 ± 17.0, and pandemic period mean age was 68.07 ± 15.1 years. The majority of the cases in both periods were male (57.9% and 63.2%). Length of stay, cost and mortality rates were significantly higher in the pandemic group (p: 0.000). There was a significant positive correlation between length of stay and cost (p: 0.000). Conclusion: It was found that intensive care costs increased considerably during the COVID 19 period, along with the increases in the length of stay and mortality rates. Advanced age and increase in length of stay were found to be correlated with mortality, but only length of stay was correlated with cost.

Keywords:

COVID - 19, Length Of Stay ICU Cost, Mortality,

PDF

___

[1] WHO Coronavirus Disease (COVID-19) Dashboard 2021. available from: URL: https://covid19.who.int/
[2] Khan AA, AlRuthia Y, Balkhi B, Alghadeer SM, Temsah MH, Althunayyan SM, Alsofayan YM. Survival and estimation of direct medical costs of hospitalized COVID-19 patients in the Kingdom of Saudi Arabia. Int J Environ Res Public Health. 2020;17(20):7458
[3] Qiang Wang NS, Jinxin Huang, Tingting Cui, Liuqing Yang, Jing Ai, Hong Ji, Ke Xu, Tauseef Ahmad, Changjun Bao, Hui Jin. Effectiveness and cost-effectiveness of public health measures to control COVID-19: A modelling study. medRxiv. 2021.
[4] Gupta S, Hayek SS, Wang W, Chan L, Mathews KS, Melamed ML. Factors associated with death in critically Ill patients with coronavirus disease 2019 in the US. JAMA Intern Med. 2020;180(11):1436-1447.
[5] Petrilli CM, Jones SA, Yang J, Rajagopalan H, O’Donnell L, Chernyak Y. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ. 2020;369. doi: https://doi.org/10.1136/bmj.m1966
[6] Lavery AM, Preston LE, Ko JY, Chevinsky JR, DeSisto CL, Pennington AF. Characteristics of Hospitalized COVID-19 Patients Discharged and Experiencing Same-Hospital Readmission – United States, March-August 2020. MMWR Morb Mortal Wkly Rep. 2020;69(45):1695-1699.
[7] Di Fusco M, Shea KM, Lin J, Nguyen JL, Angulo FJ, Benigno M. Health outcomes and economic burden of hospitalized COVID-19 patients in the United States. J Med Econ.2021;24(1):308-317.
[8] Bartsch SM, Ferguson MC, McKinnell JA, O’Shea KJ, Wedlock PT, Siegmund SS. The potential health care costs and resource use associated with COVID-19 in the United States. Health Aff (Millwood). 2020;39(6):927-35.
[9] Haase N, Plovsing R, Christensen S, Poulsen LM, Brochner AC, Rasmussen BS, Helleberg M, Jensen JUS, Andersen LPK, Siegel H, Ibsen M, Jørgensen V, Winding R, Iversen S, Pedersen HP, Madsen J, Sølling C, Garcia RS, Michelsen J, Mohr T, Mannering A, Espelund US, Bundgaard H, Kirkegaard L, Smitt M, Buck DL, Ribergaard NE, Pedersen HS, Christensen BV, Perner A. Characteristics, interventions, and longer term outcomes of COVID-19 ICU patients in Denmark-A nationwide, observational study. Acta Anaesthesiol Scand. 2021;65(1):68- 75.
[10] Pijls BG, Jolani S, Atherley A, Derckx RT, Dijkstra JIR, Franssen GHL, Hendriks S, Richters A, Venemans-Jellema A, Zalpuri S, Zeegers MP. Demographic risk factors for COVID-19 infection, severity, ICU admission and death: a meta-analysis of 59 studies. BMJ Open. 2021;11(1):e044640. Available from: URL: https://bmjopen.bmj.com/content/11/1/e044640.
[11] Armstrong RA, Kane AD, Kursumovic E, Oglesby FC, Cook TM. Mortality in patients admitted to intensive care with COVID-19: An updated systematic review and meta-analysis of observational studies. Anaesthesia. 2021; 76(4): 537-548.