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Mechanical ventilation as a major driver of COVID-19 hospitalization costs: a costing study in a German setting

Author

Listed:
  • Leslie R. Zwerwer

    (University of Groningen, University Medical Center Groningen
    University of Groningen)

  • Jan Kloka

    (University Hospital Frankfurt, Goethe University)

  • Simon Pol

    (University of Groningen, University Medical Center Groningen
    Health-Ecore)

  • Maarten J. Postma

    (University of Groningen, University Medical Center Groningen
    Health-Ecore
    University of Groningen)

  • Kai Zacharowski

    (University Hospital Frankfurt, Goethe University)

  • Antoinette D. I. Asselt

    (University of Groningen, University Medical Center Groningen
    University of Groningen, University Medical Center Groningen)

  • Benjamin Friedrichson

    (University Hospital Frankfurt, Goethe University)

Abstract

Background While COVID-19 hospitalization costs are essential for policymakers to make informed health care resource decisions, little is known about these costs in western Europe. The aim of the current study is to analyze these costs for a German setting, track the development of these costs over time and analyze the daily costs. Methods Administrative costing data was analyzed for 598 non-Intensive Care Unit (ICU) patients and 510 ICU patients diagnosed with COVID-19 at the Frankfurt University hospital. Descriptive statistics of total per patient hospitalization costs were obtained and assessed over time. Propensity scores were estimated for length of stay (LOS) at the general ward and mechanical ventilation (MV) duration, using covariate balancing propensity score for continuous treatment. Costs for each additional day in the general ward and each additional day in the ICU with and without MV were estimated by regressing the total hospitalization costs on the LOS and the presence or absence of several treatments using generalized linear models, while controlling for patient characteristics, comorbidities, and complications. Results Median total per patient hospitalization costs were €3,010 (Q1 – Q3: €2,224—€5,273), €5,887 (Q1 – Q3: €3,054—€10,879) and €21,536 (Q1 – Q3: €7,504—€43,480), respectively, for non-ICU patients, non-MV and MV ICU patients. Total per patient hospitalization costs for non-ICU patients showed a slight increase over time, while total per patient hospitalization costs for ICU patients decreased over time. Each additional day in the general ward for non-ICU COVID-19 patients costed €463.66 (SE: 15.89). Costs for each additional day in the general ward and ICU without and with mechanical ventilation for ICU patients were estimated at €414.20 (SE: 22.17), €927.45 (SE: 45.52) and €2,224.84 (SE: 70.24). Conclusions This is, to our knowledge, the first study examining the costs of COVID-19 hospitalizations in Germany. Estimated costs were overall in agreement with costs found in literature for non-COVID-19 patients, except for higher estimated costs for mechanical ventilation. These estimated costs can potentially improve the precision of COVID-19 cost effectiveness studies in Germany and will thereby allow health care policymakers to provide better informed health care resource decisions in the future.

Suggested Citation

  • Leslie R. Zwerwer & Jan Kloka & Simon Pol & Maarten J. Postma & Kai Zacharowski & Antoinette D. I. Asselt & Benjamin Friedrichson, 2024. "Mechanical ventilation as a major driver of COVID-19 hospitalization costs: a costing study in a German setting," Health Economics Review, Springer, vol. 14(1), pages 1-17, December.
    • Handle: RePEc:spr:hecrev:v:14:y:2024:i:1:d:10.1186_s13561-023-00476-1
    DOI: 10.1186/s13561-023-00476-1
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    References listed on IDEAS

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    1. Zsolt Mogyorosy & Peter Smith, 2005. "The main methodological issues in costing health care services: A literature review," Working Papers 007cherp, Centre for Health Economics, University of York.
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