"Bring the Hoses to Where the Fire Is!": Differential Impacts of Marginalization and Socioeconomic Status on COVID-19 Case Counts and Healthcare Costs.
In: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, Jg. 25 (2022-08-01), Heft 8, S. 1307-1316
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Zugriff:
Objectives: Local health leaders and the Director General of the World Health Organization alike have observed that COVID-19 "does not discriminate." Nevertheless, the disproportionate representation of people of low socioeconomic status among those infected resembles discrimination. This population-based retrospective cohort study examined COVID-19 case counts and publicly funded healthcare costs in Ontario, Canada, with a focus on marginalization.
Methods: Individuals with their first positive severe acute respiratory syndrome coronavirus 2 test from January 1, 2020 to June 30, 2020, were linked to administrative databases and matched to negative/untested controls. Mean net (COVID-19-attributable) costs were estimated for 30 days before and after diagnosis, and differences among strata of age, sex, comorbidity, and measures of marginalization were assessed using analysis of variance tests.
Results: We included 28 893 COVID-19 cases (mean age 54 years, 56% female). Most cases remained in the community (20 545, 71.1%) or in long-term care facilities (4478, 15.5%), whereas 944 (3.3%) and 2926 (10.1%) were hospitalized, with and without intensive care unit, respectively. Case counts were skewed across marginalization strata with 2 to 7 times more cases in neighborhoods with low income, high material deprivation, and highest ethnic concentration. Mean net costs after diagnosis were higher for males ($4752 vs $2520 for females) and for cases with higher comorbidity ($1394-$7751) (both P < .001) but were similar across levels of most marginalization dimensions (range $3232-$3737, all P ≥ .19).
Conclusions: This study suggests that allocating resources unequally to marginalized individuals may improve equality in outcomes. It highlights the importance of reducing risk of COVID-19 infection among marginalized individuals to reduce overall costs and increase system capacity.
(Copyright © 2022. Published by Elsevier Inc.)
| Titel: |
"Bring the Hoses to Where the Fire Is!": Differential Impacts of Marginalization and Socioeconomic Status on COVID-19 Case Counts and Healthcare Costs.
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| Autor/in / Beteiligte Person: | Cheung, DC ; Bremner, KE ; Tsui, TCO ; Croxford, R ; Lapointe-Shaw, L ; Giudice, LD ; Mendlowitz, A ; Perlis, N ; Pataky, RE ; Teckle, P ; Zeitouny, S ; Wong, WWL ; Sander, B ; Peacock, S ; Krahn, MD ; Kulkarni, GS ; Mulder, C |
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| Zeitschrift: | Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, Jg. 25 (2022-08-01), Heft 8, S. 1307-1316 |
| Veröffentlichung: | Jan./Feb. 2011- : New York : Elsevier ; <i>Original Publication</i>: Malden, MA : Blackwell Science, c1998-, 2022 |
| Medientyp: | academicJournal |
| ISSN: | 1524-4733 (electronic) |
| DOI: | 10.1016/j.jval.2022.03.019 |
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