Objectives
The objectives of the study were to describe the characteristics of Covid-19 patients hospitalised, the level of intensity of care that was required for their management and in particular the ventilation status, and to estimate the direct medical costs of these hospitalisations to the French national health insurance.
Methods
The study included all patients hospitalised with an ICD-10 diagnostic code for Covid-19 between 1st January 2020 and 31st December 2020 and stratified into 4 ventilations: status without and with oxygen support (O2), with non-invasive ventilation (NIV), with mechanical ventilation (MV) based on medical procedure. Due to underreporting of procedures related to oxygen support, status “without O2” was combined to O2 status. Risk factors for complications were identified based on the list defined by the French National Health Authority. Cost estimation of hospitalisation was determined from the DRG.
Results
199,455 patients were included for 238,582 stays. 1% of stays were in NIV status, 8% in MV. Median age was 69 years and 54% of patients were men. Men were overrepresented in NIV and MV. 10% of people over 80 had MV. 34% of patients had no risk factor (11% of MV, 6% of NIV and 36% of O2). 16% of patients died (14% of O2, 25% of NIV, 36% of MV). The mortality rate increased with the age, between 1 and 5% for patients younger than 60 years to 33% for patients older than 80 years old. The mean cost of Covid-19 hospitalisation was €5,510 (€+/- 7,142) and the median €3,800. It increased with ventilation support intensity from €3,990 (€+/- 3,021) for O2, €10, 600 (€+/- 5,534) for NIV, €21,100 (€+/- 15,343) for MV.
Conclusions
Age, sex and risk factor increased the severity of ventilation support, cost and mortality rates. Elderly people had less MV support, shorter length of stay and lower cost.