PDF(Pubmed)
Abstract：
OBJECTIVE: To estimate hospital services utilisation and cost among the Indonesian population enrolled in the National Health Insurance (NHI) program before and after COVID-19 hospital treatment.
METHODS: 28,159 Indonesian NHI enrolees treated with laboratory-confirmed COVID-19 in hospitals between May and August 2020 were compared to 8,995 individuals never diagnosed with COVID-19 in 2020. A difference-in-difference approach is used to contrast the monthly all-cause utilisation rate and total claims of hospital services between these two groups. A period of nine months before and three to six months after hospital treatment were included in the analysis.
RESULTS: A substantial short-term increase in hospital services utilisation and cost before and after COVID-19 treatment was observed. Using the fifth month before treatment as the reference period, we observed an increased outpatient visits rate in 1-3 calendar months before and up to 2-4 months after treatment (p<0.001) among the COVID-19 group compared to the comparison group. We also found a higher admissions rate in 1-2 months before and one month after treatment (p<0.001). Consequently, increased hospital costs were observed in 1-3 calendar months before and 1-4 calendar months after the treatment (p<0.001). The elevated hospital resource utilisation was more prominent among individuals older than 40. Overall, no substantial increase in hospital outpatient visits, admissions, and costs beyond four months after and five months before COVID-19 treatment.
CONCLUSIONS: Individuals with COVID-19 who required hospital treatment had considerably higher healthcare resource utilisation in the short-term, before and after the treatment. These findings indicated that the total cost of treating COVID-19 patients might include the pre- and post-acute period.
METHODS: 28,159 Indonesian NHI enrolees treated with laboratory-confirmed COVID-19 in hospitals between May and August 2020 were compared to 8,995 individuals never diagnosed with COVID-19 in 2020. A difference-in-difference approach is used to contrast the monthly all-cause utilisation rate and total claims of hospital services between these two groups. A period of nine months before and three to six months after hospital treatment were included in the analysis.
RESULTS: A substantial short-term increase in hospital services utilisation and cost before and after COVID-19 treatment was observed. Using the fifth month before treatment as the reference period, we observed an increased outpatient visits rate in 1-3 calendar months before and up to 2-4 months after treatment (p<0.001) among the COVID-19 group compared to the comparison group. We also found a higher admissions rate in 1-2 months before and one month after treatment (p<0.001). Consequently, increased hospital costs were observed in 1-3 calendar months before and 1-4 calendar months after the treatment (p<0.001). The elevated hospital resource utilisation was more prominent among individuals older than 40. Overall, no substantial increase in hospital outpatient visits, admissions, and costs beyond four months after and five months before COVID-19 treatment.
CONCLUSIONS: Individuals with COVID-19 who required hospital treatment had considerably higher healthcare resource utilisation in the short-term, before and after the treatment. These findings indicated that the total cost of treating COVID-19 patients might include the pre- and post-acute period.
摘要：
目标：评估参加国家健康保险（NHI）计划的印尼人口在COVID-19医院治疗前后的医院服务利用率和成本。
方法：将2020年5月至8月期间在医院接受实验室确认的COVID-19治疗的28,159名印度尼西亚NHI患者与2020年从未诊断出COVID-19的8,995名个体进行比较。使用差异差异方法来比较这两组之间每月的全因利用率和医院服务的总索赔。分析包括医院治疗前9个月和住院后3至6个月的时间。
结果：观察到COVID-19治疗前后医院服务利用率和成本的短期大幅增加。以治疗前第五个月为参考期，与对照组相比,我们观察到COVID-19组治疗前1-3个月和治疗后2-4个月的门诊量增加(p<0.001).我们还发现治疗前1-2个月和治疗后1个月的入院率较高（p<0.001）。因此,在治疗前1-3个日历月和治疗后1-4个日历月观察到住院费用增加(p<0.001).医院资源利用率的提高在40岁以上的人群中更为突出。总的来说,医院门诊量没有大幅增加，招生，以及COVID-19治疗后四个月和治疗前五个月的费用。
结论：需要住院治疗的COVID-19患者短期内的医疗资源利用率要高得多，治疗前后。这些结果表明，治疗COVID-19患者的总成本可能包括急性期和急性期。
方法：将2020年5月至8月期间在医院接受实验室确认的COVID-19治疗的28,159名印度尼西亚NHI患者与2020年从未诊断出COVID-19的8,995名个体进行比较。使用差异差异方法来比较这两组之间每月的全因利用率和医院服务的总索赔。分析包括医院治疗前9个月和住院后3至6个月的时间。
结果：观察到COVID-19治疗前后医院服务利用率和成本的短期大幅增加。以治疗前第五个月为参考期，与对照组相比,我们观察到COVID-19组治疗前1-3个月和治疗后2-4个月的门诊量增加(p<0.001).我们还发现治疗前1-2个月和治疗后1个月的入院率较高（p<0.001）。因此,在治疗前1-3个日历月和治疗后1-4个日历月观察到住院费用增加(p<0.001).医院资源利用率的提高在40岁以上的人群中更为突出。总的来说,医院门诊量没有大幅增加，招生，以及COVID-19治疗后四个月和治疗前五个月的费用。
结论：需要住院治疗的COVID-19患者短期内的医疗资源利用率要高得多，治疗前后。这些结果表明，治疗COVID-19患者的总成本可能包括急性期和急性期。
