The impact of COVID-19 on inpatient costs in an intensive care unit: a retrospective study with quantitative modeling

Abstract

Due to its potential severity and rate of dissemination, SARS-CoV-2 has raised the demand for ICU beds, with unknown economic effects on public and private health care. The aim of this study was to estimate the impact of patients with COVID-19 on ICU costs. A retrospective study, with 544 patients admitted to the intensive care unit (ICU), was performed in a private hospital in Southern Brazil. Were analyzed differences in health care costs between patients admitted with COVID-19 or by other causes using Mann-Whitney statistical tests and distribution plots. Ordinary least squares were also applied for estimating ICU costs. Out of 544 hospitalizations, 40 were identified with COVID-19. The median length of stay was seven days (interquartile range [IQR], 3·3–32·5) for patients with COVID-19 and two days (IQR, 1–5) for other patients (p-value < 0·1%). The main cost differences involved medications and medical supplies (p-value < 0·1%). The median of total costs with COVID-19 was R$ 51,752 (IQR, 16,764–149,479), while that for non-COVID-19 causes was R$ (Brazilian Real) 9,935 (IQR, 6,431–19,771). The biggest differences were found in men and in patients over 60 years old (p-value < 0·1%). Hospitalizations by COVID-19 increased direct ICU costs by 36% (95% CI 10–67%). Patients diagnosed with COVID-19 significantly increased ICU costs due to their extended length of stay and severity, particularly considering the use of medications and medical supplies; this illustrates the damage caused by this infection and the lack of knowledge on proper treatment.