Journal of medical economics · 2025
Quantifying all-cause healthcare resource utilization and costs of children with mild-to-moderate long COVID in France.
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Yang Jingyan, Tamberou Cheikh, Arnee Elise, Squara Pierre-Alexandre, Boukhlal Ayoub, Nguyen Jennifer L, Volkman Hannah R, Fievez Stephane, Lepoutre-Bourguet Marina, Ben Romdhane Haifa, Renaudat Charlotte, Crépey Pascal, Robineau Olivier
Аннотация
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.
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.