Healthcare costs of COVID-19 and osteoarthritis in Brazil

• Grant number: 25/04890-8
• Support Opportunities: Scholarships in Brazil - Master
• Start date: May 01, 2025
• End date: April 30, 2027
• Field of knowledge: Health Sciences - Physiotherapy and Occupational Therapy
• Principal Investigator: Gisela Cristiane Miyamoto
• Grantee: Frederico de Carvalho Barbosa Ferreira
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated research grant: 23/02147-0 - Implementation of research in economic evaluation in health: cost-of-illness, utility measures and statistical methods, AP.JP

Abstract

Cost-of-illness studies are partial economic evaluations that can identify unnecessary expenditures in health services, assisting decision-makers on how to best allocate resources, producing clinical guidelines, and informing national health policy. However, there is a gap in the economic impact of different health conditions in Brazil. Thus, the aim of this project will be to estimate the healthcare costs of two impactful health conditions, coronavirus 19 (COVID-19) and osteoarthritis in Brazil. This project consists of two retrospective cohort cost-of-illness studies using registry-based data. These studies will be conducted from the perspective of the Unified Health System (Sistema Único de Saúde - SUS) using macro-costing and top-down approaches with a time horizon of 5 years for COVID-19 and 10 years for osteoarthritis. Prevalence will be the epidemiological approach used in this study. Therefore, the real impact of existing cases will be identified, which will represent the total consumption of health resources in the SUS with COVID-19 and osteoarthritis. Healthcare costs will consist of inpatient care costs and outpatient care costs. Data on resource use amounts for COVID-19 between 2020 and 2024 and for osteoarthritis between 2015 and 2024 and the respective costs recorded in the Department of Informatics of the Unified Health System (Departamento de Informática do SUS - DATASUS) will be extracted using the Brazilian Ministry of Health's management and costing system. Inpatient care data will be derived from the Hospital Information System (SIH) and outpatient care data will be derived from the Ambulatory Information System (SIA). Inpatient care costs will be extracted considering the following categories: personnel services, in-hospital service, intensive care unit service, and companion's daily. Outpatient care costs will be extracted considering the following categories: diagnostic procedures, therapeutic and minor surgical procedures, assistive devices, and supplementary services. Data from adults over 18 years-old, both sexes, and registered with the International Classification of Diseases 10th Revision (ICD-10) code related to COVID-19 (B34.2 - coronavirus infection, unspecified site) and osteoarthritis (M15: polyosteoarthritis; M16: hip osteoarthritis; M17: knee osteoarthritis; M18: first carpometacarpal joint osteoarthritis; M19: other osteoarthritis) will be extracted and processed using the TAB-WIN v.1.4.1 software. In this national database, it is only possible to extract aggregated data from the population. Therefore, it is not possible to extract individual data from each patient who used health services in the SUS, making it impossible to estimate costs per patient. All extracted data will be organized into spreadsheets in Microsoft Excel software. Costs will be extracted in Brazilian Real (R$) and converted to 2024 International Dollar (I$) using the purchasing power parity approach. Healthcare costs (the sum of inpatient care and outpatient care costs), inpatient care costs, and outpatient care costs will be presented descriptively. Inpatient care costs and outpatient care costs will also be reported separately by category. The results of the studies in this project will show the economic impact of COVID-19 and osteoarthritis in Brazil. These studies will identify healthcare costs in inpatient and outpatient care in the period 2020 to 2024 for COVID-19 and 2015 to 2024 for osteoarthritis, investigating the increase or decrease in costs over time. In addition, it will be possible to identify whether osteoarthritis costs were affected during the COVID-19 pandemic, comparing the periods before, during, and after the pandemic.