Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive Study

Background: Assessing the financial burden of COVID-19 is important for planning health services and resource allocation to inform future pandemic response. Objectives: This study examines the changing dynamics in healthcare utilization patterns and costs from a public healthcare perspective during...

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Main Authors: Kathy Liu, Elissa Rennert-May, Zuying Zhang, Adam G D’Souza, Alysha Crocker, Tyler Williamson, Reed Beall, Jenine Leal
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Health Services Insights
Online Access:https://doi.org/10.1177/11786329241306390
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author Kathy Liu
Elissa Rennert-May
Zuying Zhang
Adam G D’Souza
Alysha Crocker
Tyler Williamson
Reed Beall
Jenine Leal
author_facet Kathy Liu
Elissa Rennert-May
Zuying Zhang
Adam G D’Souza
Alysha Crocker
Tyler Williamson
Reed Beall
Jenine Leal
author_sort Kathy Liu
collection DOAJ
description Background: Assessing the financial burden of COVID-19 is important for planning health services and resource allocation to inform future pandemic response. Objectives: This study examines the changing dynamics in healthcare utilization patterns and costs from a public healthcare perspective during the COVID-19 pandemic in Alberta, Canada. Design: Population-based descriptive study. Methods: All adult patients over the age of 18 years who had a laboratory-confirmed COVID-19 diagnosis in Alberta, Canada from March 1, 2020 to December 15, 2021. We described demographic information and community- and hospital-based healthcare utilization and costs. We compared changes in each outcome throughout the first four waves of the pandemic. Results: Among 255,037 patients, hospitalization incurred significantly higher costs ( N  = 20,603; aRR = 755.51; marginal cost: $21,738.17 CAD; P  < .01). Wave 2 recorded the highest cost for Emergency Department (ED) visits (aRR = 1.10; marginal cost: $79.19 CAD; P  < .01). Compared to Wave 1, Waves 2-4 all recorded significantly lower costs for out-patient visits. Wave 2’s in-patient cost for patients that required ICU admission was significantly lower than Wave 1 (aRR = 0.75; marginal cost: −$24,142.47 CAD; P  = .02). Conclusion: COVID-19 exerted a heavy toll on healthcare services, and the dynamics of this continue to evolve. Utilization of ED and in-patient services were particularly high. Severe infections requiring hospitalization and ICU admission are more expensive than non-hospitalized and non-ICU hospital admits. Future studies should clarify specific factors, such as sociodemographic determinants, that contribute to evolving patterns of health services consumption and changing trends in cost to holistically inform responses to future pandemics.
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spelling doaj-art-475347cd809149b492dfc4ef1c192e192025-08-20T02:34:31ZengSAGE PublishingHealth Services Insights1178-63292024-12-011710.1177/11786329241306390Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive StudyKathy Liu0Elissa Rennert-May1Zuying Zhang2Adam G D’Souza3Alysha Crocker4Tyler Williamson5Reed Beall6Jenine Leal7Department of Community Health Sciences, University of Calgary, Calgary, AB, CanadaSnyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, AB, CanadaAnalytics, Alberta Health Services, Calgary, AB, CanadaAlberta Health Services, Calgary, AB, CanadaLibin Cardiovascular Institute, Calgary, AB, CanadaDepartment of Community Health Sciences, University of Calgary, Calgary, AB, CanadaO’Brien Institute for Public Health, University of Calgary, Calgary, AB, CanadaBackground: Assessing the financial burden of COVID-19 is important for planning health services and resource allocation to inform future pandemic response. Objectives: This study examines the changing dynamics in healthcare utilization patterns and costs from a public healthcare perspective during the COVID-19 pandemic in Alberta, Canada. Design: Population-based descriptive study. Methods: All adult patients over the age of 18 years who had a laboratory-confirmed COVID-19 diagnosis in Alberta, Canada from March 1, 2020 to December 15, 2021. We described demographic information and community- and hospital-based healthcare utilization and costs. We compared changes in each outcome throughout the first four waves of the pandemic. Results: Among 255,037 patients, hospitalization incurred significantly higher costs ( N  = 20,603; aRR = 755.51; marginal cost: $21,738.17 CAD; P  < .01). Wave 2 recorded the highest cost for Emergency Department (ED) visits (aRR = 1.10; marginal cost: $79.19 CAD; P  < .01). Compared to Wave 1, Waves 2-4 all recorded significantly lower costs for out-patient visits. Wave 2’s in-patient cost for patients that required ICU admission was significantly lower than Wave 1 (aRR = 0.75; marginal cost: −$24,142.47 CAD; P  = .02). Conclusion: COVID-19 exerted a heavy toll on healthcare services, and the dynamics of this continue to evolve. Utilization of ED and in-patient services were particularly high. Severe infections requiring hospitalization and ICU admission are more expensive than non-hospitalized and non-ICU hospital admits. Future studies should clarify specific factors, such as sociodemographic determinants, that contribute to evolving patterns of health services consumption and changing trends in cost to holistically inform responses to future pandemics.https://doi.org/10.1177/11786329241306390
spellingShingle Kathy Liu
Elissa Rennert-May
Zuying Zhang
Adam G D’Souza
Alysha Crocker
Tyler Williamson
Reed Beall
Jenine Leal
Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive Study
Health Services Insights
title Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive Study
title_full Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive Study
title_fullStr Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive Study
title_full_unstemmed Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive Study
title_short Evaluation of In-Hospital and Community-Based Healthcare Utilization and Costs During the Coronavirus 2019 (COVID-19) Pandemic in Alberta, Canada: A Population-Based Descriptive Study
title_sort evaluation of in hospital and community based healthcare utilization and costs during the coronavirus 2019 covid 19 pandemic in alberta canada a population based descriptive study
url https://doi.org/10.1177/11786329241306390
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