Table 3.
Population-level DCEA outcomes.
| Subgroups | Total population within each subgroup∗ | Average starting patient QALE† | Health benefits from COVID-19 inpatient treatment (QALYs)‡ | Health losses (per opportunity costs) (QALYs)§ | Net health benefits (QALYs) |
|---|---|---|---|---|---|
| HQ1 | 4 143 362 | 71.22 | 4061 | (2955) | 1106 |
| HQ2 | 7 473 781 | 69.91 | 11 641 | (5331) | 6310 |
| HQ3 | 9 992 513 | 68.76 | 25 014 | (7127) | 17 887 |
| HQ4 | 18 289 880 | 67.75 | 66 714 | (13 045) | 53 668 |
| HQ5 | 14 018 354 | 65.90 | 82 082 | (9999) | 72 083 |
| BQ1 | 3 251 954 | 70.26 | 3942 | (2319) | 1622 |
| BQ2 | 5 621 186 | 68.94 | 10 731 | (4009) | 6722 |
| BQ3 | 8 037 859 | 67.87 | 23 742 | (5733) | 18 009 |
| BQ4 | 12 066 135 | 66.84 | 53 796 | (8606) | 45 190 |
| BQ5 | 7 875 448 | 64.98 | 52 959 | (5617) | 47 342 |
| WQ1 | 34 435 697 | 70.45 | 52 011 | (24 561) | 27 450 |
| WQ2 | 34 445 350 | 69.75 | 84 185 | (24 568) | 59 617 |
| WQ3 | 35 177 231 | 68.00 | 134 316 | (25 090) | 109 226 |
| WQ4 | 31 837 920 | 67.06 | 178 064 | (22 708) | 155 355 |
| WQ5 | 14 803 158 | 65.19 | 124 540 | (10 558) | 113 982 |
| Total/average | 241 469 828 | 68.20 | 907 797 | (172 228) | 735 569 |
B indicates non-Hispanic black; DCEA, distributional cost-effectiveness analysis; H, Hispanic; QALE, quality-adjusted life expectancy; QALY, quality-adjusted life-year; W, non-Hispanic white.
Total population based on subgroups: the total US population modeled is based on the remaining 810 US counties in our sample (see Methods).
Average patient QALE: this estimate represents the average population before considering inpatient COVID-19 interventions. Given the lag in reporting of mortality data and the large observed impact of COVID-19 on mortality, estimates of QALE (in years) derived from US data were further adjusted to reflect QALY losses owing to COVID-19 by estimating average years lost due to COVID-19 for hospitalized patients (based on age and setting of care) multiplied by the number of hospitalized patients in the subgroup. This was done by calculating the expected total QALYs of an individual under standard-of-care treatment in the hospital by taking a weighted average between the subgroup-specific disability-free expected life expectancy and the average age of patients in the CEA model.
Health benefits from COVID-19 inpatient treatment: estimate reflects the incremental QALY gains per COVID-19 patient treated inpatient that are scaled based on the estimated number of hospitalized patients in the subgroup.
Health losses (opportunity costs): the model base-case scenario assumes that opportunity costs are borne equally across the full population. Estimates above were based on the total opportunity costs per a $150 000 opportunity cost threshold, distributed across subgroups based on relative population sizes.