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. 2023 Sep 20;18(9):e0283651.
doi: 10.1371/journal.pone.0283651. eCollection 2023.

Costs of inpatient care and out-of-pocket payments for COVID-19 patients: A systematic review

Kamal Gholipour  1 , Sama Behpaie  2 , Shabnam Iezadi  3 , Akbar Ghiasi  4 , Jafar Sadegh Tabrizi  1
Affiliations

Costs of inpatient care and out-of-pocket payments for COVID-19 patients: A systematic review

Kamal Gholipour et al. PLoS One. .

Abstract

Objective: To identify the costs of hospital care for patients with COVID-19 and the amount of out-of-pocket payments.

Methods: We conducted a systematic review using Scopus and WEB OF SCIENCE and PubMed databases in April 5, 2022 and then updated in January 15, 2023. English articles with no publication year restrictions were included with study designs of cost-of-illness (COI) studies, cost analyses, and observational reports (cross-sectional studies and prospective and retrospective cohorts) that calculated the patient-level cost of care for COVID-19. Costs are reported in USD with purchasing power parity (PPP) conversion in 2020. The PROSPERO registration number is CRD42022334337.

Results: The results showed that the highest total cost of hospitalization in intensive care per patient was 100789 USD, which was reported in Germany, and the lowest cost was 5436.77 USD, which was reported in Romania. In the present study, in the special care department, the highest percentage of total expenses is related to treatment expenses (42.23 percent), while in the inpatient department, the highest percentage of total expenses is related to the costs of hospital beds/day of routine services (39.07 percent). The highest percentage of out-of-pocket payments was 30.65 percent, reported in China, and the lowest percentage of out-of-pocket payments was 1.12 percent, reported in Iran. The highest indirect cost per hospitalization was 16049 USD, reported in USA, and the lowest was 449.07 USD, reported in India.

Conclusion: The results show that the COVID-19 disease imposed a high cost of hospitalization, mainly the cost of hospital beds/day of routine services. Studies have used different methods for calculating the costs, and this has negatively impacted the comparability costs across studies. Therefore, it would be beneficial for researchers to use a similar cost calculation model to increase the compatibility of different studies. Systematic review registration: PROSPERO CRD42022334337.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram for systematic reviews.
Fig 2
Fig 2. Cost drivers of hospitalization due to COVID-19 ICU per country, Data are presented as a percentage (%) of the total cost.
Fig 3
Fig 3. Cost drivers of hospitalization due to COVID-19 Ward per country, Data are presented as a percentage (%) of the total cost.
Fig 4
Fig 4. Cost drivers of hospitalization due to COVID-19 in studies in which it was not possible to separate the cost of hospitalization in the ward and the ICU, data are presented as a percentage (%) of the total cost.
Fig 5
Fig 5. Indirect cost due to COVID-19 per country.
Data are presented as a percentage (%) of the total cost.
Fig 6
Fig 6. Out of pocket due to COVID-19 per country.
Data are presented as a percentage (%) of the total cost.
See this image and copyright information in PMC

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