Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis.

IF 8.8 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of the Royal Society of Medicine Pub Date : 2024-11-01 Epub Date: 2024-11-27 DOI:10.1177/01410768241288345

Yi Mu, Ashkan Dashtban, Mehrdad A Mizani, Chris Tomlinson, Mohamed Mohamed, Mark Ashworth, Mamas Mamas, Rouven Priedon, Steffen Petersen, Evan Kontopantelis, Kim Horstmanshof, Christina Pagel, Mevhibe Hocaoğlu, Kamlesh Khunti, Richard Williams, Johan Thygesen, Paula Lorgelly, Manuel Gomes, Melissa Heightman, Amitava Banerjee

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引用次数: 0

Abstract

Objectives: To investigate healthcare utilisation and cost in individuals with long COVID (LC) at population level.

Design: Case-control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID only, no LC; (2) pre-pandemic; (3) contemporary non-COVID; and (4) pre-LC (self-controlled, pre-COVID pandemic).

Setting: National, population-based, linked UK electronic health records (British Heart Foundation/NHS England Secure Data Environment).

Participants: Adults aged ≥18 years with LC between January 2020 and January 2023.

Main outcome measures: Healthcare utilisation (number of consultations/visits per person: primary care (general practitioner [GP]), secondary care (outpatient [OP], inpatient [IP] and emergency department [ED], investigations and procedures) and inflation-adjusted cost (£) for LC and control populations per month, calendar year and pandemic year for each category.

Results: A total of 282,080 individuals with LC were included between January 2020 and January 2023. The control groups were COVID only, no LC (n = 1,112,370), pre-pandemic (n = 1,031,285), contemporary non-COVID (n = 1,118,360) and pre-LC (n = 282,080). Healthcare utilisation per person (per month/year) was higher in LC than controls across GP, OP and ED. For IP, LC had higher healthcare utilisation than pre-LC and contemporary non-COVID (all p < 0.0001). Healthcare utilisation of the LC group increased progressively between 2020 and 2023, compared with controls. Median cost per patient/year was also higher in individuals with LC than all control groups.

Conclusions: LC has been associated with substantial, persistent healthcare utilisation and cost over the last three years. Future funding, resources and staff for LC prevention, treatment and research must be prioritised to reduce sustained primary and secondary healthcare utilisation and costs.

查看原文本刊更多论文

282,080名长程COVID患者两年来的医疗保健使用情况：多重匹配对照纵向队列分析。

目的调查人群中长期慢性阻塞性肺病（LC）患者的医疗利用率和成本：病例对照队列分析，包括多个年龄、性别、种族、贫困程度、地区和合并症匹配的对照组：(1) 仅 COVID，无 LC；(2) 大流行前；(3) 当代非 COVID；(4) LC 前（自我控制，COVID 大流行前）：全国性、基于人群、链接的英国电子健康记录（英国心脏基金会/英格兰国家医疗服务系统安全数据环境）：主要结果测量：医疗保健利用率（每人咨询/就诊次数：初级保健（全科医生[GP]）、二级保健（门诊[OP]、住院[IP]和急诊科[ED]、检查和手术）以及 LC 和对照人群每月、日历年和大流行年每类的通货膨胀调整后成本（英镑）：在 2020 年 1 月至 2023 年 1 月期间，共纳入 282,080 名 LC 患者。对照组为仅有 COVID、无 LC（n = 1,112,370）、大流行前（n = 1,031,285）、当代非 COVID（n = 1,118,360）和 LC 前（n = 282,080）。在全科医生、手术室和急诊室方面，低血糖患者的人均医疗保健使用率（月/年）高于对照组。就 IP 而言，低血糖患者的医疗保健使用率高于低血糖前患者和当代非低血糖患者（均为 p 结论）：在过去三年中，低血糖与大量、持续的医疗使用和成本有关。今后必须优先考虑为 LC 的预防、治疗和研究提供资金、资源和人员，以减少持续的初级和中级医疗保健使用率和成本。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the Royal Society of Medicine 医学-医学：内科

CiteScore

8.40

自引率

3.50%

发文量

107

审稿时长

6-12 weeks

期刊介绍： Since 1809, the Journal of the Royal Society of Medicine (JRSM) has been a trusted source of information in the medical field. Our publication covers a wide range of topics, including evidence-based reviews, original research papers, commentaries, and personal perspectives. As an independent scientific and educational journal, we strive to foster constructive discussions on vital clinical matters. While we are based in the UK, our articles address issues that are globally relevant and of interest to healthcare professionals worldwide.