Comparing postacute care healthcare charges after hospitalisation due to influenza or COVID-19 infection in an all-payer administrative dataset in the USA: a retrospective cohort study

Abstract

Objective SARS-CoV-2 infection often causes a persistent syndrome of multiorgan dysfunction with symptoms that may be debilitating. Individuals seeking care for this syndrome are likely to generate significant healthcare utilisation and spending. It is unknown if healthcare costs after SARS-CoV-2 infection differ from those after influenza infection.Methods and analysis We used an all-payer administrative dataset comprised coding and billing data from 446 hospitals in the USA that use a financial analytics platform by Strata Decision Technology. The deidentified analytical sample included patients aged 18 years or older who were admitted to a hospital between July 2018 and May 2021 with an International Classification of Disease-10 code for COVID-19 or influenza. Analyses were stratified by age (18–44, 45–64 and 65+) and need for ventilation during acute hospitalisation. Linear regression models were used to evaluate the relationship between infection type (COVID-19 or influenza) and cumulative charges between 1 and 5 months after hospitalisation. Independent variables included medical comorbidities, health system classification and prehospitalisation charges, among others.Results Of 110 381 patients included in our analysis, 94 927 (86.0%) were hospitalised for COVID-19 and 15 454 (14.0%) were hospitalised for influenza. Patients hospitalised for COVID-19 generated a median of US$5248 (inter-quartile range (IQR) US$25693) in postacute healthcare charges, whereas patients hospitalised for influenza generated a median of US$8463 (IQR US$41063). Compared with influenza, linear model results demonstrated no significant differences in postacute charges among patients hospitalised with COVID-19.Conclusion Our findings suggest that individual healthcare expenditures after acute COVID-19 infection are not significantly different from those after influenza infection.