Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar 11;17(3):e0265003.
doi: 10.1371/journal.pone.0265003. eCollection 2022.

Hospitalization costs of coronaviruses diseases in upper-middle-income countries: A systematic review

César Ramos Rocha-Filho  1 , Johnny Wallef Leite Martins  2 , Rosa Camila Lucchetta  3   4 , Gabriel Sodré Ramalho  5 , Giulia Fernandes Moça Trevisani  6 , Aline Pereira da Rocha  1 , Ana Carolina Pereira Nunes Pinto  1   7 , Felipe Sebastião de Assis Reis  8 , Laura Jantsch Ferla  5 , Patrícia de Carvalho Mastroianni  2   3 , Luci Correa  9 , Humberto Saconato  10 , Virgínia Fernandes Moça Trevisani  1   6   10
Affiliations

Hospitalization costs of coronaviruses diseases in upper-middle-income countries: A systematic review

César Ramos Rocha-Filho et al. PLoS One. .

Abstract

Background: COVID-19, SARS and MERS are diseases that present an important health burden worldwide. This situation demands resource allocation to the healthcare system, affecting especially middle- and low-income countries. Thus, identifying the main cost drivers is relevant to optimize patient care and resource allocation.

Objective: To systematically identify and summarize the current status of knowledge on direct medical hospitalization costs of SARS, MERS, or COVID-19 in Upper-Middle-Income Countries.

Methods: We conducted a systematic review across seven key databases (PubMed, EMBASE, BVS Portal, CINAHL, CRD library, MedRxiv and Research Square) from database inception to February 2021. Costs extracted were converted into 2021 International Dollars using the Purchasing Power Parity-adjusted. The assessment of quality was based on the protocol by the BMJ and CHEERS. PROSPERO 2020: CRD42020225757.

Results: No eligible study about SARS or MERS was recovered. For COVID-19, five studies presented cost analysis performed in Brazil, China, Iran, and Turkey. Regarding total direct medical costs, the lowest cost per patient at ward was observed in Turkey ($900.08), while the highest in Brazil ($5,093.38). At ICU, the lowest was in Turkey ($2,984.78), while the highest was in China ($52,432.87). Service care was the most expressive (58% to 88%) cost driver of COVID-19 patients at ward. At ICU, there was no consensus between service care (54% to 87%) and treatment (72% to 81%) as key burdens of total cost.

Conclusion: Our findings elucidate the importance of COVID-19 on health-economic outcomes. The marked heterogeneity among studies leaded to substantially different results and made challenging the comparison of data to estimate pooled results for single countries or regions. Further studies concerning cost estimates from standardized analysis may provide clearer data for a more substantial analysis. This may help care providers and policy makers to organize care for patients in the most efficient way.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram.
Adapted from Page et al. (2021) [10].
Fig 2
Fig 2. Cost drivers of hospitalization due to COVID-19 at ward and ICU per country.
Data are presented as a percentage (%) of total cost. 1Severe case. 2Critical case.
Fig 3
Fig 3. Methodology assessment of included studies based on the checklist provided by Oliveira, Itria and Lima [8].
Graphic produced with robvis, provided by McGuinnes and Higgins [17].
See this image and copyright information in PMC

References

    1. Zhu Z, Lian X, Su X, Wu W, Marraro GA, Zeng Y. From SARS and MERS to COVID-19: a brief summary and comparison of severe acute respiratory infections caused by three highly pathogenic human coronaviruses. Respir Res. 2020. Aug 27;21(1):224. doi: 10.1186/s12931-020-01479-w . - DOI - PMC - PubMed
    1. Chan-Yeung M, Xu RH. SARS: epidemiology. Respirology. 2003. Nov;8 Suppl(Suppl 1):S9–14. doi: 10.1046/j.1440-1843.2003.00518.x . - DOI - PMC - PubMed
    1. Nassar MS, Bakhrebah MA, Meo SA, Alsuabeyl MS, Zaher WA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: epidemiology, pathogenesis and clinical characteristics. Eur Rev Med Pharmacol Sci. 2018. Aug;22(15):4956–4961. doi: 10.26355/eurrev_201808_15635 . - DOI - PubMed
    1. World Health Organization. WHO Coronavirus (COVID-19) Dashboard [Internet]. [cited 2021 Jun 7];Available from: https://covid19.who.int/.
    1. Chaiyakunapruk N, Kotirum S, Newall AT, Lambach P, Hutubessy RCW. Rationale and opportunities in estimating the economic burden of seasonal influenza across countries using a standardized WHO tool and manual. Influenza Other Respir Viruses. 2018. Jan;12(1):13–21. doi: 10.1111/irv.12491 Epub 2017 Nov 16. . - DOI - PMC - PubMed

Publication types