Long COVID (post-COVID-19 condition) is the condition associated with the long-term effects of a COVID-19 infection. According to NICE, Long COVID can be diagnosed when symptoms, such as fatigue and shortness of breath, are persistent for over 4 weeks and cannot be explained by an alternative diagnosis.
The prevalence of Long COVID condition is high in the UK. As of 5th March 2022, 2.7% of the UK population were experiencing self-reported Long COVID. The Office for National Statistics (ONS) estimate that approximately 10% of individuals with COVID-19 exhibit symptoms over 12 weeks after initial infection. Initial research has shown that due to the prolonged symptoms after testing positive for COVID-19, patients have shown significantly higher GP consultation rates for most symptoms and diseases. The increased utilisation of health care resources is likely to have cost implications for the NHS.
Currently, there is no available research estimating whether post-COVID-19 condition has led to higher primary health care costs, and if so, estimating the size of this cost. This study intends to address this gap by using UK primary care data to compare and quantify the difference in the cost of primary care utilisation (consultations) between non-hospitalised patients who have tested positive for COVID-19 and matched uninfected non-hospitalised patients. The results of this study will help guide healthcare resource planning and future cost analysis studies related to the COVID-19 pandemic.
As of 5th March 2022, 2.7% of the UK population were experiencing self-reported Long COVID. This burden has steadily increased over the last year. Research has shown that, in comparison to uninfected patients, those who have been infected by COVID-19, were at a higher risk of reporting a range of symptoms and have presented significantly higher hazard ratios for general practitioner (GP) consultation rates, post-infection. Subsequently, it is likely that individuals suffering from post-COVID-19 condition have presented higher primary care costs.
An incremental costing approach will be used to estimate the extra cost of primary care utilisation due to post-COVID-19 condition. The design of the study is a retrospective matched cohort study, where uninfected patients will be propensity score matched to patients who have been infected by SARS-CoV-2. The assumption is that the only difference between the matched patients is their infection status. Any difference in primary care cost is then attributable to post-COVID-19 condition. The costing method will be bottom-up and prevalence-based. The calculation will be the unit cost of the primary care consultation multiplied by a patient’s resource use.
The results will be stratified by demographics to investigate whether the costs differ amongst patient groups, aiding the direction of policy implications. For sensitivity analysis, costs will be calculated for those still showing symptoms at various time periods since infection (e.g., 12 weeks or more). Multivariate regression methods will also be used to estimate the cost of post-COVID-19 condition and to assess how different covariates are associated with the cost. This will provide insights which will improve healthcare resource allocation, policy, and future research.
Primary outcome:
Cost of primary care utilisation: The number, staff-role assigned, and type of consultation utilised by a patient in a primary care setting.
Shamil Haroon - Chief Investigator - University of Birmingham
Jake Tufts - Corresponding Applicant - University of Birmingham
Anuradhaa Subramanian - Collaborator - University of Birmingham
Dawit Zemedikun - Collaborator - University of Birmingham
Krishnarajah Nirantharakumar - Collaborator - University of Birmingham
Louise Jackson - Collaborator - University of Birmingham
Practice Level Index of Multiple Deprivation