Journal of Health Economics and Outcomes Research (Apr 2021)

The Economic Impact of COVID-19 Treatment at a Hospital-level: Investment and Financial Registers of Brazilian Hospitals

  • Ana Paula Beck da Silva Etges,
  • Ricardo Bertoglio Cardoso,
  • Milena Marcolino,
  • Karen Brasil Ruschel,
  • Ana Paula Coutinho,
  • Elayne Crestani Pereira,
  • Fernando Anschau,
  • Filipe Carrilho,
  • Giovanna Vietta,
  • Gisele Alsina Nader Bastos,
  • Joanna d’Arc Lyra Batista,
  • José Miguel Chatkin,
  • Juliana da Silva Nogueira,
  • Leila Beltrami Moreira,
  • Luciana Haddad,
  • Maiara Floriani,
  • Marília Teixeira de Siqueira,
  • Patrícia Ziegelmann,
  • Petrônio José de Lima Martelli,
  • Roberta Pozza,
  • Umbelina Cravo Teixeira Lagioia,
  • Carisi Anne Polanczyk,
  • Luciane Kopittke

Abstract

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**Background:** The economic impact associated with the treatment strategies of coronavirus disease-2019 (COVID-19) patients by hospitals and health-care systems in Brazil is unknown and difficult to estimate. This research describes the investments made to absorb the demand for treatment and the changes in occupation rates and billing in Brazilian hospitals. **Methods:** This research covers the initial findings of “COVID-19 hospital costs and the proposition of a bundled reimbursement strategy for the health-care system,” which includes 10 hospitals. The chief financial officer, the chief medical officer, and hospital executives of each participating hospital provided information regarding investments attributed to COVID-19 patient treatment. The analysis included variations in occupation rates and billing from 2019 to 2020 observed in each institution, and the investments for medical equipment, individual protection materials and building construction per patient treated. **Results:** The majority of hospitals registered a decrease in hospitalization rates and revenue from 2019 to 2020. For intensive care units (ICUs), the mean occupancy rate ranged from 88% to 83%, and for wards, it ranged from 85% to 73%. Monthly average revenue decreased by 10%. The mean hospital investment per COVID-19 inpatient was I$6800 (standard deviation 7664), with the purchase of ventilators as the most common investment. For this item, the mean, highest and lowest acquisition cost per ventilator were, respectively, I$31 468, I$48 881 and I$17 777. **Conclusion:** There was significant variability in acquisition costs and investments by institution for responding to the COVID-19 pandemic. These findings highlight the importance of continuing microeconomic studies for a comprehensive assessment of hospital costs. Only with more detailed analyses, will it be possible to define and drive sustainable strategies to manage and reimburse COVID-19 treatment in health-care systems.