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Quantifying all-cause healthcare resource utilization and costs of children with mild-to-moderate long COVID in
Jingyan Yang1,2, Cheikh Tamberou3, Elise Arnee3
1Global Access and Value, Pfizer Inc, New York, NY, USA.
Insights
Long COVID in children incurs significant healthcare costs, with 14.1% of cases leading to substantial resource utilization and an incremental cost increase of €98 per patient annually. This highlights the economic impact on French health insurance.
Area of Science:
- Pediatric Health Economics
- Infectious Disease Epidemiology
- Public Health Policy
Background:
- Children are susceptible to developing long COVID, but the economic implications are not well understood.
- Assessing the economic burden of long COVID in pediatric populations is crucial for healthcare planning.
- Previous research has not adequately described the healthcare resource utilization and costs associated with pediatric long COVID.
Purpose of the Study:
- To evaluate the all-cause healthcare resource utilization (HCRU) in children with mild-to-moderate long COVID in France.
- To determine the direct medical costs associated with long COVID in pediatric patients.
- To provide a national health insurance perspective on the economic burden of pediatric long COVID.
Main Methods:
- Retrospective cohort study using The Health Improvement Network (THIN) primary care electronic health records.
- Identified children under 18 with confirmed/probable COVID-19 and subsequent long COVID symptoms (≥3 months post-infection).
- Analyzed patient characteristics, HCRU (encounters, procedures, pharmacy, testing, caregiver sick leave, transport, devices), and direct healthcare costs.
Main Results:
- 14.1% of 27,537 children diagnosed with acute COVID-19 developed long COVID (mean age 8.9 years).
- During 12.6 months follow-up, 93.6% had GP consultations, 93.5% pharmacy usage, and 61.0% medical procedures.
- First-year costs averaged €823 per patient; long COVID diagnosis added €98 per patient annually compared to controls.
Conclusions:
- Long COVID in community-managed children represents a significant financial burden on French health insurance.
- Effective management of pediatric long COVID requires a multidisciplinary approach.
- Optimizing resource allocation is essential to mitigate the economic impact of long COVID in children.
Background:
Although children are known to be at risk of developing long COVID, its economic burden is poorly described. We aimed to assess the all-cause healthcare resource utilization (HCRU) and associated direct medical costs of children with mild-to-moderate long COVID in France.
Methods:
This retrospective cohort study utilized The Health Improvement Network (THIN) primary care electronic health records to identify children aged <18 years with confirmed/probable COVID-19 diagnoses during March 2020 to December 2022 who developed long COVID, identified per the World Health Organization as suggestive symptoms present ≥3 months following SARS-CoV-2 infection. Patient characteristics, all-cause HCRU and direct healthcare costs from a national health insurance perspective were summarized. HCRU and costs were stratified into healthcare encounters, medical procedures, retail pharmacy usage, testing, caregiver sick leave, medical transport, and medical device usage.
Results:
Of 27,537 children diagnosed with acute COVID-19, 3,888 (14.1%) developed long COVID; mean age was 8.9 years, 49.2% were female and, among those with comorbidity, 24.5% had a Charlson Comorbidity Index score ≥1. During a mean post-diagnosis follow-up of 12.6 months, 93.6% of children had general practitioner consultations, 93.5% had pharmacy usage, and 61.0% had medical procedures. First-year costs were highest at €823 per patient per year; 4.3% of children required caregiver-related work absenteeism. Compared to children who did not develop long COVID, a long COVID diagnosis was associated with an incremental cost increase of €98 per patient per year.
Limitations:
Our findings only represent a national payer perspective. The true societal burden of long COVID in children is likely underestimated since long COVID-related indirect costs are not fully captured and access to care varies.
Conclusion:
Children living with long COVID managed in the community pose a non-neglectable burden on French health insurance, reinforcing the importance of managing long COVID with a multidisciplinary approach and optimizing resource allocation.
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