Patient Characteristics and Costs Associated With COVID-19-Related Medical Care Among Medicare Fee-for-Service Beneficiaries
Patient Characteristics and Costs Associated With COVID-19-Related Medical Care Among Medicare Fee-for-Service Beneficiaries
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DOI：
10.7326/m21-1102
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发表时间：
2021-08-01
影响因子：
39.2
通讯作者：
Zhou, Fangjun
中科院分区：
文献类型：
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作者：
Tsai, Yuping;Vogt, Tara M.;Zhou, Fangjun
背景：美国每天都有新的COVID-19病例发生，对医疗的需求持续增长。对COVID-19治疗的直接医疗费用的了解有限。目的：研究老年人COVID-19的特征及其COVID-19相关医疗护理的费用。设计：回顾性观察性研究。设置：医疗保险按服务收费（FFS）受益人的医疗索赔。患者：在2020年4月至12月期间有过COVID-19相关医疗遭遇的65岁或以上Medicare FFS受益人。结果：在2810万Medicare FFS受益人中，有1181127人（4.2%）寻求COVID-19相关的医疗护理。在这些患者中，23.0%的患者住院，4.2%的患者在住院期间死亡。大多数患者为女性（57.0%）、非西班牙裔白色人（79.6%）和城市县居民（77.2%）。2019冠状病毒病相关医疗护理的联邦医疗保险FFS成本为63亿美元; 92.6%的成本用于住院治疗。平均住院费用为21752美元，平均住院时间为9.2天;如果患者需要呼吸机（49441美元和17.1天）或死亡（32015美元和11.3天），则住院费用和住院时间更高。每次门诊的平均费用为164美元。年龄在75岁或以上的患者更有可能住院，但他们的住院费用低于年轻患者。男性和非白人种族/民族与更高的住院概率和更高的医疗费用相关。局限性：结果基于Medicare FFS患者。结论：COVID-19大流行给美国老年人，特别是非白人种族/民族的老年人带来了巨大的疾病和经济负担。
Background: New cases of COVID-19 continue to occur daily in the United States, and the need for medical treatments continues to grow. Knowledge of the direct medical costs of COVID-19 treatments is limited.Objective: To examine the characteristics of older adults with COVID-19 and their costs for COVID-19-related medical care.Design: Retrospective observational study.Setting: Medical claims for Medicare fee-for-service (FFS) beneficiaries.Patients: Medicare FFS beneficiaries aged 65 years or older who had a COVID-19-related medical encounter during April through December 2020.Measurements: Patient characteristics and direct medical costs of COVID-19-related hospitalizations and outpatient visits.Results: Among 28.1 million Medicare FFS beneficiaries, 1 181 127 (4.2%) sought COVID-19-related medical care. Among these patients, 23.0% had an inpatient stay and 4.2% died during hospitalization. The majority of the patients were female (57.0%), non-Hispanic White (79.6%), and residents of an urban county (77.2%). Medicare FFS costs for COVID-19 related medical care were $6.3 billion; 92.6% of costs were for hospitalizations. The mean hospitalization cost was $21 752, and the mean length of stay was 9.2 days; hospitalization cost and length of stay were higher if the patient needed a ventilator ($49 441 and 17.1 days) or died ($32 015 and 11.3 days). The mean cost per outpatient visit was $164. Patients aged 75 years or older were more likely to be hospitalized, but their hospitalizations were associated with lower costs than for younger patients. Male sex and non-White race/ethnicity were associated with higher probability of being hospitalized and higher medical costs.Limitation: Results are based on Medicare FFS patients.Conclusion: The COVID-19 pandemic has resulted in substantial disease and economic burden among older Americans, particularly those of non-White race/ethnicity.