COVID-19 in Multimorbid Patients-A Controlled Microcost Description Analysis of Diagnosis Related Group (DRG)-Case Series in Acute Care without Non-Invasive Ventilation.

Tobias Romeyke,Harald Stummer

doi:10.3390/clinpract11040090

Abstract

Diagnosis-related cost analyzes are important for health economic planning and decision-making. They form the basis for further developing of remuneration systems for health services. The rapid increase in hospital stays by COVID-19 patients requires a valid and exact calculation of the treatment costs. COVID-19 patients with many accompanying illnesses increase the requirements for a cost calculation. The focus of this work is to carry out a DRG-related micro-cost analysis, considering the age, length of stay and comorbidities of COVID-19 patients. So far, there is little information about treatment costs for multimorbid patients with COVID-19 who have not received invasive ventilation. The method is based on a standardized cost unit calculation for determining the treatment costs in a German hospital. The costs (€) of inpatients treated with COVID-19 were compared with a control group of the same DRGs of patients without COVID-19. The average total costs for inpatient treatment were €2866. The highest share of costs falls on nursing, personnel, and material costs of the non-medical infrastructure. Frequent comorbidities were heart failure, diabetes mellitus, other respiratory diseases, dizziness, and impairment of the musculoskeletal system.

Highlights

Due to the rapid spread of the coronavirus disease 2019 (COVID-19) worldwide, it was declared a pandemic by the World Health Organization (WHO) at the beginning of March 2020 [1].Many patients had to be treated as inpatients due to their state of health caused by COVID-19
It is assumed that the medical costs caused by COVID-19 patients are higher than compared to other infectious diseases due to necessary hospital stays [4]
The average age of the patients suffering from COVID-19 (SARS-CoV-2 reverse transcription polymerase chain reaction test was administered, following World Health Organization protocols (WHO 13.03.20)) was 74.4 years

Summary

Introduction

Many patients had to be treated as inpatients due to their state of health caused by COVID-19. Comorbidities, such as diabetes or high blood pressure, have a negative impact on the course of the disease, which often requires referral to intensive care units [2,3]. When the capacities of the ICUs (intensive care unit) become scarce, patients in smaller hospitals must continue to receive care. There are few studies examining hospital costs caused by COVID-19. It is assumed that the medical costs caused by COVID-19 patients are higher than compared to other infectious diseases due to necessary hospital stays [4]

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Discussion

Conclusion