RWD2 Variation in COVID-19 Treatment Cost due to Social Factors in the US – Estimation Using Integration of CDC/ATSDR’s Social Vulnerability Index (SVI) and Healthcare Claims Data

Abstract

ObjectiveThis study explored the variation in COVID-19 treatment cost by Social Vulnerability Index (SVI) of patients in the US.MethodThis study included patients diagnosed with COVID-19 infection between 1st March 2020 to 30th June 2021 with ICD-10-CM diagnosis recorded in the large de-identified database of the US health insurance claims representing ∼15% population. Only the patients having continuous eligibility of 1-month post (follow-up period) the first diagnosis of COVID-19 (index date) were included in study. Zip code (if available) closest to COVID-19 diagnosis index of those patient were joined with The Minority Health SVI (mhSVI) file to map patient’s SVI score ranged from 0 to 1. We have estimated medical cost post-index across the four patient groups, categorized based on SVI score (Group 1: 0-0.25; Group 2: 0.251-50; Group 3: 0.501-.75; Group 4: 0.751-1) and have applied the statistical test to analyze the level of significance in cost variation across the four SVI groups. Results will be stratified further by place of service – Inpatient, Emergency, Outpatient.ResultsAmong 306,652 patients diagnosed with COVID-19, we were able to map SVI score for 98% of patients. We have observed four times more medical cost for patients who have SVI score >0.75 than <0.25. Estimated mean medical cost of group 1 (Least socially vulnerable) to group 4 (Highly socially vulnerable) were as follows: $1,108 (SD $7,407), $1,777 (SD $10,886), $2,605 (SD $13,562), $4,374 (SD $20,935).ConclusionSignificant variation in COVID-19 treatment cost might be corelated with patient’s severe COVID-19 presentation, higher exposure to risk factors, and other co-morbid condition in socially vulnerable population. This study helps to guide healthcare resource planning and allocation for emergency preparedness in the socially vulnerable communities. ObjectiveThis study explored the variation in COVID-19 treatment cost by Social Vulnerability Index (SVI) of patients in the US. This study explored the variation in COVID-19 treatment cost by Social Vulnerability Index (SVI) of patients in the US. MethodThis study included patients diagnosed with COVID-19 infection between 1st March 2020 to 30th June 2021 with ICD-10-CM diagnosis recorded in the large de-identified database of the US health insurance claims representing ∼15% population. Only the patients having continuous eligibility of 1-month post (follow-up period) the first diagnosis of COVID-19 (index date) were included in study. Zip code (if available) closest to COVID-19 diagnosis index of those patient were joined with The Minority Health SVI (mhSVI) file to map patient’s SVI score ranged from 0 to 1. We have estimated medical cost post-index across the four patient groups, categorized based on SVI score (Group 1: 0-0.25; Group 2: 0.251-50; Group 3: 0.501-.75; Group 4: 0.751-1) and have applied the statistical test to analyze the level of significance in cost variation across the four SVI groups. Results will be stratified further by place of service – Inpatient, Emergency, Outpatient. This study included patients diagnosed with COVID-19 infection between 1st March 2020 to 30th June 2021 with ICD-10-CM diagnosis recorded in the large de-identified database of the US health insurance claims representing ∼15% population. Only the patients having continuous eligibility of 1-month post (follow-up period) the first diagnosis of COVID-19 (index date) were included in study. Zip code (if available) closest to COVID-19 diagnosis index of those patient were joined with The Minority Health SVI (mhSVI) file to map patient’s SVI score ranged from 0 to 1. We have estimated medical cost post-index across the four patient groups, categorized based on SVI score (Group 1: 0-0.25; Group 2: 0.251-50; Group 3: 0.501-.75; Group 4: 0.751-1) and have applied the statistical test to analyze the level of significance in cost variation across the four SVI groups. Results will be stratified further by place of service – Inpatient, Emergency, Outpatient. ResultsAmong 306,652 patients diagnosed with COVID-19, we were able to map SVI score for 98% of patients. We have observed four times more medical cost for patients who have SVI score >0.75 than <0.25. Estimated mean medical cost of group 1 (Least socially vulnerable) to group 4 (Highly socially vulnerable) were as follows: $1,108 (SD $7,407), $1,777 (SD $10,886), $2,605 (SD $13,562), $4,374 (SD $20,935). Among 306,652 patients diagnosed with COVID-19, we were able to map SVI score for 98% of patients. We have observed four times more medical cost for patients who have SVI score >0.75 than <0.25. Estimated mean medical cost of group 1 (Least socially vulnerable) to group 4 (Highly socially vulnerable) were as follows: $1,108 (SD $7,407), $1,777 (SD $10,886), $2,605 (SD $13,562), $4,374 (SD $20,935). ConclusionSignificant variation in COVID-19 treatment cost might be corelated with patient’s severe COVID-19 presentation, higher exposure to risk factors, and other co-morbid condition in socially vulnerable population. This study helps to guide healthcare resource planning and allocation for emergency preparedness in the socially vulnerable communities. Significant variation in COVID-19 treatment cost might be corelated with patient’s severe COVID-19 presentation, higher exposure to risk factors, and other co-morbid condition in socially vulnerable population. This study helps to guide healthcare resource planning and allocation for emergency preparedness in the socially vulnerable communities.