Abstract
BackgroundCOVID-19, SARS and MERS are diseases that present an important health burden worldwide. This situation demands resource allocation to the healthcare system, affecting especially middle- and low-income countries. Thus, identifying the main cost drivers is relevant to optimize patient care and resource allocation.ObjectiveTo systematically identify and summarize the current status of knowledge on direct medical hospitalization costs of SARS, MERS, or COVID-19 in Upper-Middle-Income Countries.MethodsWe conducted a systematic review across seven key databases (PubMed, EMBASE, BVS Portal, CINAHL, CRD library, MedRxiv and Research Square) from database inception to February 2021. Costs extracted were converted into 2021 International Dollars using the Purchasing Power Parity-adjusted. The assessment of quality was based on the protocol by the BMJ and CHEERS. PROSPERO 2020: CRD42020225757.ResultsNo eligible study about SARS or MERS was recovered. For COVID-19, five studies presented cost analysis performed in Brazil, China, Iran, and Turkey. Regarding total direct medical costs, the lowest cost per patient at ward was observed in Turkey ($900.08), while the highest in Brazil ($5,093.38). At ICU, the lowest was in Turkey ($2,984.78), while the highest was in China ($52,432.87). Service care was the most expressive (58% to 88%) cost driver of COVID-19 patients at ward. At ICU, there was no consensus between service care (54% to 87%) and treatment (72% to 81%) as key burdens of total cost.ConclusionOur findings elucidate the importance of COVID-19 on health-economic outcomes. The marked heterogeneity among studies leaded to substantially different results and made challenging the comparison of data to estimate pooled results for single countries or regions. Further studies concerning cost estimates from standardized analysis may provide clearer data for a more substantial analysis. This may help care providers and policy makers to organize care for patients in the most efficient way.
Highlights
Within the first two decades, the 21st century was marked by three coronavirus outbreaks: Severe Acute Respiratory Syndrome (SARS) Coronavirus (SARS-CoV), Middle East Respiratory Syndrome (MERS) Coronavirus (MERS-CoV) and, most recently, the SARS Coronavirus 2 (SARS-CoV-2) [1].The SARS-CoV epidemic occurred from 2002 to 2003, presenting no new cases since 2004, totalizing 8,422 cases and 916 deaths, with a fatality rate of 11% [2]
At Intensive Care Units (ICU), the lowest was in Turkey ($2,984.78), while the highest was in China ($52,432.87)
At ICU, there was no consensus between service care (54% to 87%) and treatment (72% to 81%) as key burdens of total cost
Summary
The SARS-CoV epidemic occurred from 2002 to 2003, presenting no new cases since 2004, totalizing 8,422 cases and 916 deaths, with a fatality rate of 11% [2]. MERS-CoV, from 2012 to 2018, infected over 2,000 people globally, mostly in Middle Eastearn countries. Along with the marked clinical impact, the battle against the coronaviruses demands several resources, elevating the healthcare costs. Healthcare systems and national governments may use data on the economic burden of infectious diseases as evidence to make informed decisions to allocate limited resources optimally and to prioritize interventions in their public or local policies [5,6]. COVID-19, SARS and MERS are diseases that present an important health burden worldwide. This situation demands resource allocation to the healthcare system, affecting especially middle- and low-income countries. Identifying the main cost drivers is relevant to optimize patient care and resource allocation
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