Direct Medical Cost Analysis of Indian COVID-19 Patients Requiring Critical Care Admission

Kamini N Reddy; Jignesh Shah; Shivakumar Iyer; Monidipa Chowdhury; Naveen Yerrapalem; Neeraja Pasalkar; Prashant P Jedge

doi:10.5005/jp-journals-10071-23991

Direct Medical Cost Analysis of Indian COVID-19 Patients Requiring Critical Care Admission

Indian J Crit Care Med. 2021 Oct;25(10):1120-1125. doi: 10.5005/jp-journals-10071-23991.

Authors

Kamini N Reddy¹, Jignesh Shah¹, Shivakumar Iyer¹, Monidipa Chowdhury², Naveen Yerrapalem², Neeraja Pasalkar², Prashant P Jedge¹

Affiliations

¹ Department of Critical Care Medicine, Bharati Vidyapeeth (Deemed to be University), Medical College, Pune, Maharashtra, India.
² Department of Clinical Pharmacy, Bharati Vidyapeeth (Deemed to be University), Medical College, Pune, Maharashtra, India.

Abstract

Introduction: Intensive care unit (ICU) admission is required for approximately 25% of patients affected with coronavirus disease-19 (COVID-19) and imposes a high economic burden on patients in resource-limited settings.

Method: We conducted a retrospective direct medical care cost analysis of COVID-19 patients requiring ICU admission after obtaining the Institutional Ethics Committee approval. Data were obtained from the records of patients admitted to the COVID-19 ICU of a tertiary care trust teaching hospital from June 2020 to December 2020. Direct costs were analyzed and correlated with various demographic variables and clinical outcomes.

Results: A total of 176 patients were included (males-76%). The median direct medical cost for a median stay of 13 days was INR 202248.5 ($ 2742.91). Hospital drugs and disposables accounted for 20% of the total cost followed by bed charges (19%), equipment charges (17%), biosafety protective gear (15.5%), pathological and radiological tests (15%), clinical management (7.6%), and biomedical waste management (1.6%). Government schemes accounted for 79% of medical claims followed by directly paying patients (12.5%) and private insurance (8.5%). The cost was significantly higher in patients with diabetes mellitus and sepsis and in those requiring mechanical ventilation (MV) (p <0.05). Shorter lead time to hospital admission and lesser length of hospital stay were associated with significant lower direct cost.

Conclusion: Direct medical care cost is substantial for COVID-19 patients requiring ICU admission. This cost is significantly associated with increased ICU and hospital stay, longer lead time to admission, diabetes mellitus, sepsis, and those who need high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), and MV.

How to cite this article: Reddy KN, Shah J, Iyer S, Chowdhury M, Yerrapalem N, Pasalkar N, et al. Direct Medical Cost Analysis of Indian COVID-19 Patients Requiring Critical Care Admission. Indian J Crit Care Med 2021;25(10):1120-1125.

Keywords: COVID-19; Cost; Intensive care unit.