COVID-19 emerged as a new threat to the global healthcare system and continues to have an incremental impact, both on the health of people and the economy.
As health systems struggle to meet the increased care demands resulting from the pandemic, whilst having to deal with these in an ever-more resource constrained environment, efforts are required towards developing better risk mitigation and management strategies that allows for better resource allocation and prioritization planning. Evidence on the risk factors for COVID-19 hospitalization, mortality, hospital stay and cost of treatment in the African context, however, is limited.
A recent study conducted by Dr Geetesh Solanki and colleagues at the SAMRC’s Health Systems Research Unit (HSRU) published in the PLOS ONE journal, aimed to quantify the impact of known risk factors on COVID-19 hospitalization and mortality and hospitalization-related utilization and expenditure in a large South African private health insured population. This was a cross sectional analytic study and based on the analysis of the records of members belonging to health insurances administered by Discovery Health (PTY) Ltd. Demographic data for 188,292 members who tested COVID-19 positive over the period 1 March 2020–28 February 2021 and the hospitalisation data for these members up until 30 June 2021. Logistic regression models were used for hospitalisation and death outcomes, while length of hospital stay and (log) cost per patient were modelled by negative binominal and linear regression models. The study design accounted for potential differences in the population served and the quality of care within different geographic health regions by including the health district as a random effect.
Significance of findings
Overall, hospitalisation and mortality risks were 18.8% and 3.3%, respectively. Individuals who were aged 65+ years, exhibited three or more comorbidities and males had the highest hospitalisation and mortality risks and the longest and costliest hospital stays. It was found that hospitalisation and mortality risks were higher in the second wave compared to the first. Hospital and mortality risks varied across provinces, even after controlling for important predictors. Furthermore, hospitalisation and mortality risks were the highest for diabetes alone or in combination with hypertension, hypercholesterolemia and ischemic heart disease.
Dr Solanki said, ‘’this paper is the first to present COVID-19 outcomes amongst a private health insured population in Africa and will contribute to addressing the gap in the knowledge base on the actual observed COVID-19 risks and subsequent hospitalization using real world data.” He concluded that this would enable targeted patient management strategies and risk stratification, identification of opportunities for provider quality and efficiency improvements and will generate information to assess the cost and cost effectiveness of preventative and treatment interventions for patients with COVID-19.
To read the full paper | Click HERE