Abstract：
To analyze US commercial insurance payments associated with COVID-19 as a function of severity and duration of disease.
Retrospective database analysis.
Patients with COVID-19 between April 1, 2020, and June 30, 2021, in the Merative MarketScan Commercial database were identified and stratified as having asymptomatic, mild, moderate (with and without lower respiratory disease), or severe/critical (S/C) disease based on the severity of the acute COVID-19 infection. Duration of disease (DOD) was estimated for all patients. Patients with DOD longer than 12 weeks were defined as having post-COVID-19 condition (PCC). Outcomes were all-cause payments (ACP) and disease-specific payments (DSP) for the entire DOD. Variables included demographic and comorbidities at the time of acute disease. Adjusted payments by disease severity were estimated using generalized linear models (γ distribution with log link).
A total of 738,339 patients were included (374,401 asymptomatic, 156,220 mild, 180,213 moderate, and 27,505 S/C cases). DSP increased from $217 (95% CI, $214-221) for asymptomatic cases to $2744 (95% CI, $2678-$2811) for moderate cases with lower respiratory disease and $28,250 (95% CI, $26,963-$29,538) for S/C cases. ACP increased from $505 (95% CI, $497-$512) for asymptomatic cases to $46,538 (95% CI, $44,096-$48,979) for S/C cases. The DSP and ACP further increased by $50,736 (95% CI, $45,337-$56,136) and $94,839 (95% CI, $88,029-$101,649), respectively, in S/C cases with PCC vs a DOD of fewer than 4 weeks.
COVID-19 payments for S/C cases were more than 10-fold greater than those of moderate cases and further increased by nearly $95,000 in S/C cases with PCC vs a DOD of fewer than 4 weeks.
Retrospective database analysis.
Patients with COVID-19 between April 1, 2020, and June 30, 2021, in the Merative MarketScan Commercial database were identified and stratified as having asymptomatic, mild, moderate (with and without lower respiratory disease), or severe/critical (S/C) disease based on the severity of the acute COVID-19 infection. Duration of disease (DOD) was estimated for all patients. Patients with DOD longer than 12 weeks were defined as having post-COVID-19 condition (PCC). Outcomes were all-cause payments (ACP) and disease-specific payments (DSP) for the entire DOD. Variables included demographic and comorbidities at the time of acute disease. Adjusted payments by disease severity were estimated using generalized linear models (γ distribution with log link).
A total of 738,339 patients were included (374,401 asymptomatic, 156,220 mild, 180,213 moderate, and 27,505 S/C cases). DSP increased from $217 (95% CI, $214-221) for asymptomatic cases to $2744 (95% CI, $2678-$2811) for moderate cases with lower respiratory disease and $28,250 (95% CI, $26,963-$29,538) for S/C cases. ACP increased from $505 (95% CI, $497-$512) for asymptomatic cases to $46,538 (95% CI, $44,096-$48,979) for S/C cases. The DSP and ACP further increased by $50,736 (95% CI, $45,337-$56,136) and $94,839 (95% CI, $88,029-$101,649), respectively, in S/C cases with PCC vs a DOD of fewer than 4 weeks.
COVID-19 payments for S/C cases were more than 10-fold greater than those of moderate cases and further increased by nearly $95,000 in S/C cases with PCC vs a DOD of fewer than 4 weeks.
摘要：
目的：分析与COVID-19相关的美国商业保险支付与疾病严重程度和持续时间的关系。
方法：回顾性数据库分析。
方法：在2020年4月1日至2021年6月30日期间，MerativeMarketScan商业数据库中的COVID-19患者被识别并分层为无症状，温和,中度（有和没有下呼吸道疾病），根据急性COVID-19感染的严重程度，或严重/危急(S/C)疾病。估计所有患者的疾病持续时间(DOD)。DOD超过12周的患者被定义为患有COVID-19后病症(PCC)。结果是整个国防部的全因付款（ACP）和特定疾病付款（DSP）。变量包括急性疾病时的人口统计学和合并症。使用广义线性模型(具有对数链接的γ分布)估计按疾病严重程度调整后的支付。
结果：共纳入738,339例患者（374,401例无症状，156,220轻度，180,213中度，和27,505个S/C案例）。DSP从无症状病例的217美元（95％CI，214-221美元）增加到中度下呼吸道疾病病例的2744美元（95％CI，2678美元-2811美元）和S/C病例的28,250美元（95％CI，26,963-29,538美元）。ACP从无症状病例的$505（95％CI，$497-$512）增加到S/C病例的$46,538（95％CI，$44,096-$48,979）。DSP和ACP进一步增加了50,736美元(95%CI，45,337美元-56,136美元)和94,839美元(95%CI，88,029美元-101,649美元)，分别,在S/C病例中，PCC与DOD小于4周。
结论：S/C病例的COVID-19支付额比中度病例高10倍以上，在S/C病例中，PCC与DOD不到4周的情况进一步增加了近95,000美元。
方法：回顾性数据库分析。
方法：在2020年4月1日至2021年6月30日期间，MerativeMarketScan商业数据库中的COVID-19患者被识别并分层为无症状，温和,中度（有和没有下呼吸道疾病），根据急性COVID-19感染的严重程度，或严重/危急(S/C)疾病。估计所有患者的疾病持续时间(DOD)。DOD超过12周的患者被定义为患有COVID-19后病症(PCC)。结果是整个国防部的全因付款（ACP）和特定疾病付款（DSP）。变量包括急性疾病时的人口统计学和合并症。使用广义线性模型(具有对数链接的γ分布)估计按疾病严重程度调整后的支付。
结果：共纳入738,339例患者（374,401例无症状，156,220轻度，180,213中度，和27,505个S/C案例）。DSP从无症状病例的217美元（95％CI，214-221美元）增加到中度下呼吸道疾病病例的2744美元（95％CI，2678美元-2811美元）和S/C病例的28,250美元（95％CI，26,963-29,538美元）。ACP从无症状病例的$505（95％CI，$497-$512）增加到S/C病例的$46,538（95％CI，$44,096-$48,979）。DSP和ACP进一步增加了50,736美元(95%CI，45,337美元-56,136美元)和94,839美元(95%CI，88,029美元-101,649美元)，分别,在S/C病例中，PCC与DOD小于4周。
结论：S/C病例的COVID-19支付额比中度病例高10倍以上，在S/C病例中，PCC与DOD不到4周的情况进一步增加了近95,000美元。
