The economic impact of COVID-19: a comparative cost analysis of ICU hospitalizations before and during the pandemic

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-03-04 DOI:10.1016/j.clinsp.2026.100891

Heloisa Helena Piva, Anna Miethke-Morais, Alex Jones Flores Cassenote, Luiz Augusto Carneiro-D´Albuquerque, Luciana Bertocco de Paiva Haddad

{"title":"The economic impact of COVID-19: a comparative cost analysis of ICU hospitalizations before and during the pandemic","authors":"Heloisa Helena Piva, Anna Miethke-Morais, Alex Jones Flores Cassenote, Luiz Augusto Carneiro-D´Albuquerque, Luciana Bertocco de Paiva Haddad","doi":"10.1016/j.clinsp.2026.100891","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 economic impact on health institutions has been discussed since the beginning of the pandemic, and the repercussions in different spheres were enormous. The economic evaluation in health became necessary as a management tool.</div></div><div><h3>Objective</h3><div>To describe and compare the hospitalization costs in Intensive Care Units (ICUs) and the patients' clinical and demographic variables, before and during the COVID-19 pandemic.</div></div><div><h3>Data sources and study setting</h3><div>Partial economic evaluation of patients admitted to four ICUs, in a Brazilian reference center, in two periods: pre-pandemic (03/30/19 ‒ 06/30/19) and pandemic (03/30/20 ‒ 06/30/20).</div></div><div><h3>Study design</h3><div>Observational cohort study.</div></div><div><h3>Data collection/Extraction methods</h3><div>Micro and macro costing methodology; clinical and demographic variables were considered for the comparative analysis.</div></div><div><h3>Results</h3><div>In 2019, 521 hospitalizations were analyzed. Patients were predominantly male (61%), between 31- and 60-years old (48.2%) and of white race (75.4%). In 2020, 610 hospitalizations were analyzed: 60.3% male, 51.6% > 60-years old and 65.2% white race. All ICUs had an increase in deaths (2019: average of 26.9%; 2020: average of 48.8%). The average total hospitalization costs and the average patient-day cost in 2019 was US$ 6051.01 and US$ 787.48, respectively; in 2020, US$ 19,492.73 and US$ 1542.74. Human resources was the component with the highest cost (2019: 51.6%; 2020: 78.2%). Patients who require additional therapeutic procedures had a higher average cost in 2020.</div></div><div><h3>Conclusion</h3><div>During COVID, patients were older (> 60-years), a higher percentage of patients identified as mixed race, the death rate was significantly higher, and the length of stay was significantly higher, resulting in the outcome “discharge”. The COVID cost was significantly higher. The main cost component was human resources, mainly during the COVID pandemic. Additional therapeutic procedures were associated with higher costs.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"81 ","pages":"Article 100891"},"PeriodicalIF":2.4000,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1807593226000323","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/3/4 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The COVID-19 economic impact on health institutions has been discussed since the beginning of the pandemic, and the repercussions in different spheres were enormous. The economic evaluation in health became necessary as a management tool.

Objective

To describe and compare the hospitalization costs in Intensive Care Units (ICUs) and the patients' clinical and demographic variables, before and during the COVID-19 pandemic.

Data sources and study setting

Partial economic evaluation of patients admitted to four ICUs, in a Brazilian reference center, in two periods: pre-pandemic (03/30/19 ‒ 06/30/19) and pandemic (03/30/20 ‒ 06/30/20).

Study design

Observational cohort study.

Data collection/Extraction methods

Micro and macro costing methodology; clinical and demographic variables were considered for the comparative analysis.

Results

In 2019, 521 hospitalizations were analyzed. Patients were predominantly male (61%), between 31- and 60-years old (48.2%) and of white race (75.4%). In 2020, 610 hospitalizations were analyzed: 60.3% male, 51.6% > 60-years old and 65.2% white race. All ICUs had an increase in deaths (2019: average of 26.9%; 2020: average of 48.8%). The average total hospitalization costs and the average patient-day cost in 2019 was US$ 6051.01 and US$ 787.48, respectively; in 2020, US$ 19,492.73 and US$ 1542.74. Human resources was the component with the highest cost (2019: 51.6%; 2020: 78.2%). Patients who require additional therapeutic procedures had a higher average cost in 2020.

Conclusion

During COVID, patients were older (> 60-years), a higher percentage of patients identified as mixed race, the death rate was significantly higher, and the length of stay was significantly higher, resulting in the outcome “discharge”. The COVID cost was significantly higher. The main cost component was human resources, mainly during the COVID pandemic. Additional therapeutic procedures were associated with higher costs.

查看原文本刊更多论文

COVID-19的经济影响：大流行之前和期间ICU住院的比较成本分析

背景：自疫情开始以来，人们一直在讨论COVID-19对卫生机构的经济影响，其在不同领域的影响是巨大的。健康经济评价作为一种管理工具变得必要。目的：描述和比较2019冠状病毒病（COVID-19）大流行前和期间重症监护病房（icu）住院费用、患者临床和人口统计学变量。数据来源和研究背景：对巴西某参考中心在两个时期(大流行前（19年3月30日- 19年6月30日）和大流行时期（20年3月30日- 20年6月30日）入住4个icu的患者进行部分经济评估。研究设计：观察性队列研究。数据收集/提取方法：微观和宏观成本核算方法；临床和人口统计学变量被用于比较分析。结果：2019年共分析了521例住院病例。患者主要为男性（61%）、31- 60岁（48.2%）和白人（75.4%）。2020年，分析了610例住院病例：60.3%为男性，51.6%为60岁以上，65.2%为白人。所有icu的死亡人数都有所增加（2019年：平均26.9%；2020年：平均48.8%）。2019年的平均总住院费用和平均患者日费用分别为6051.01美元和787.48美元；2020年为19492.73美元和1542.74美元。人力资源是成本最高的部分（2019年：51.6%；2020年：78.2%）。2020年，需要额外治疗程序的患者的平均费用更高。结论：新冠肺炎期间，患者年龄较大（60 ~ 60岁），混血患者比例较高，死亡率明显较高，住院时间明显较长，导致结局“出院”。COVID的成本明显更高。主要成本部分是人力资源，特别是在COVID大流行期间。额外的治疗程序与更高的费用相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.