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. 2021 Apr 16;8(1):36-41.
doi: 10.36469/jheor.2021.22066.

The Economic Impact of COVID-19 Treatment at a Hospital-level: Investment and Financial Registers of Brazilian Hospitals

Ana Paula Beck da Silva Etges  1 , Ricardo Bertoglio Cardoso  2 , Milena S Marcolino  3 , Karen Brasil Ruschel  4 , Ana Paula Coutinho  5 , Elayne Crestani Pereira  6 , Fernando Anschau  7 , Fernando Aranha  6 , Filipe Carrilho  8 , Giovanna Vietta  6 , Gisele Alsina Nader Bastos  9 , Joanna d'Arc Lyra Batista  10 , José Miguel Chatkin  11 , Juliana da Silva Nogueira  12 , Leila Beltrami Moreira  13 , Luciana Haddad  14 , Maiara Floriani  9 , Marília Teixeira de Siqueira  15 , Patrícia Ziegelmann  2 , Petrônio José de Lima Martelli  12 , Roberta Pozza  16 , Umbelina Cravo Teixeira Lagioia  12 , Carisi Anne Polanczyk  17 , Luciane Kopittke  7
Affiliations

The Economic Impact of COVID-19 Treatment at a Hospital-level: Investment and Financial Registers of Brazilian Hospitals

Ana Paula Beck da Silva Etges et al. J Health Econ Outcomes Res. .

Abstract

Background: The economic impact associated with the treatment strategies of coronavirus disease-2019 (COVID-19) patients by hospitals and health-care systems in Brazil is unknown and difficult to estimate. This research describes the investments made to absorb the demand for treatment and the changes in occupation rates and billing in Brazilian hospitals. Methods: This research covers the initial findings of "COVID-19 hospital costs and the proposition of a bundled reimbursement strategy for the health-care system," which includes 10 hospitals. The chief financial officer, the chief medical officer, and hospital executives of each participating hospital provided information regarding investments attributed to COVID-19 patient treatment. The analysis included variations in occupation rates and billing from 2019 to 2020 observed in each institution, and the investments for medical equipment, individual protection materials and building construction per patient treated. Results: The majority of hospitals registered a decrease in hospitalization rates and revenue from 2019 to 2020. For intensive care units (ICUs), the mean occupancy rate ranged from 88% to 83%, and for wards, it ranged from 85% to 73%. Monthly average revenue decreased by 10%. The mean hospital investment per COVID-19 inpatient was I$6800 (standard deviation 7664), with the purchase of ventilators as the most common investment. For this item, the mean, highest and lowest acquisition cost per ventilator were, respectively, I$31 468, I$48 881 and I$17 777. Conclusion: There was significant variability in acquisition costs and investments by institution for responding to the COVID-19 pandemic. These findings highlight the importance of continuing microeconomic studies for a comprehensive assessment of hospital costs. Only with more detailed analyses, will it be possible to define and drive sustainable strategies to manage and reimburse COVID-19 treatment in health-care systems.

Keywords: covid-19; covid-19 investment; economic analysis; hospital costs; hospital management; value-based health care.

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