Economic Burden of Public Health Care Was Higher than that of Hospitalization and Treatment Associated with COVID-19 In China

2020 
Background: During the coronavirus disease 2019 (COVID-19) pandemic, it is essential to evaluate the socioeconomic burden imposed on the Chinese health care system. Methods: We prospectively collected information from the Center for Disease Control and Prevention and the designated hospitals to determine the cost of public health care and hospitalization due to COVID-19. We estimated the resource use and direct medical costs per confirmed case and the costs associated with public health care per thousand people at the national level. Findings: The average costs per case for specimen collection and nucleic acid testing (NAT) were $29.49 and $53.44, respectively, while the average cost of NAT for high-risk populations was $297.94 per capita. The average costs per thousand people for epidemiological surveys, disinfectant, health education and centralized isolation were $49.54, $247.01, $90.22 and $543.72, respectively. A single hospitalization for COVID-19 in China cost an average of $3,792.69 ($2,754.82-$5,393.76) in direct medical costs incurred only during hospitalization, while the total costs associated with hospitalization were estimated to have reached nearly $31,229.39 million in China as of 20 May 2020. The cost of public health care ($6.81 billion) was 20 times that of hospitalization. Interpretation: This study highlights the magnitude of resources needed to control the COVID-19 pandemic and treat COVID-19 cases. Public health measures implemented by the Chinese government have been valuable with regard to reducing the infection rate and may be cost-effective ways to control emerging infectious diseases. Funding: Chongqing Medical University, National Natural Science Foundation of Chongqing, Ministry of Science and Technology of the People's Republic of China, National Natural Science Foundation of China, Education Commission of Chongqing, China Postdoctoral Science Foundation. Declaration of Interests: The authors declare no competing interest. Ethics Approval Statement: The Institutional Review Board at the Children’s Hospital of Chongqing Medical University gave its approval for the study.
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