Healthcare utilisation and cost among individuals with Long COVID in England and Wales: potential value of specialised post-COVID services.

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of the Royal Society of Medicine Pub Date : 2026-08-01 Epub Date: 2026-08-12 DOI:10.1177/01410768261476537

Ashkan Dashtban, Mehrdad Mizani, Yi Mu, Mamas Mamas, Evan Kontopantelis, Spiros Denaxas, Qi Huang, Kamlesh Khunti, Melissa Heightman, Rouven Priedon, Manuel Gomes, Amitava Banerjee

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引用次数: 0

Abstract

Objective: To compare healthcare utilisation and costs for Long COVID (LC) in England and Wales.

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 December 2023.

Main outcome measures: Healthcare utilisation (number of consultations/visits per person): primary care (general practitioner (GP)), secondary care (outpatient, inpatient and emergency department, investigations and procedures) and inflation-adjusted cost (£) for LC and control populations.

Results: In England (n = 295,180) and Wales (n = 7925), LC was associated with higher utilisation and costs across primary and secondary care. Mean annual total cost for LC versus contemporary controls was £6681.6 versus £2039.9 in Wales (3.27-fold) and £3378.3 versus £1355.8 in England (2.49-fold). GP consultations averaged 26.76 (SD 22.07) per person-year in the Welsh LC cohort versus 14.63 (SD 14.34) in England (absolute difference 12.13 visits/year). Cross-national multiplicative difference-in-differences estimates indicated a 25% greater relative LC-related cost increase in Wales compared with England (ratio 1.25, 95% CI 1.09-1.42), corresponding to an absolute excess of £2501 per person-year (95% CI £1707-£3270).

Conclusions: LC is associated with sustained increases in healthcare utilisation and costs in England and Wales. Our findings suggest that system-level service design may influence healthcare use and costs following COVID-19, warranting further evaluation of post-viral care models.

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英格兰和威尔士长COVID患者的医疗保健利用和成本：专业后COVID服务的潜在价值

目的：比较英格兰和威尔士长期COVID （LC）的医疗保健利用和成本。设计：病例-对照队列分析，包括多个年龄、性别、种族、贫困、地区和合并症匹配的对照组：(1)只有covid - 19，没有LC；(2)防;(3)当代非covid和(4)预lc（自我控制，covid大流行前）。设置：国家的、以人群为基础的、链接的英国电子健康记录（英国心脏基金会/NHS英格兰安全数据环境）。参与者：2020年1月至2023年12月期间患有LC的年龄大于或等于18岁的成年人。主要结果测量：医疗保健利用（每人咨询/访问次数）：初级保健（全科医生（GP）），二级保健（门诊、住院和急诊部门、调查和程序）以及LC和对照人群的通货膨胀调整成本（英镑）。结果：在英格兰（n = 295,180）和威尔士（n = 7925）， LC与初级和二级保健的较高利用率和成本相关。LC与现代对照的平均年总成本为6681.6英镑，威尔士为2039.9英镑（3.27倍），英格兰为3378.3英镑，英格兰为1355.8英镑（2.49倍）。威尔士LC队列平均每人年就诊26.76次（SD 22.07），而英格兰为14.63次（SD 14.34）（绝对差异12.13次/年）。跨国乘数差异估计表明，与英格兰相比，威尔士与lc相关的相对成本增加了25%（比率为1.25,95% CI为1.09-1.42），相当于每人每年的绝对超额费用为2501英镑（95% CI为1707- 3270英镑）。结论：LC与英格兰和威尔士医疗保健利用和成本的持续增加有关。我们的研究结果表明，系统级服务设计可能会影响COVID-19后的医疗保健使用和成本，需要进一步评估病毒后护理模式。

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.