Healthcare Resource Use and Costs under Pandemic Circumstances in The Netherlands: Results from the Lifelines COVID-19 Cohort

ABSTRACT OBJECTIVES This study aims to estimate healthcare resource use (HCRU) and direct healthcare costs of COVID-19 and post-COVID-19 condition (PCC) in the Netherlands. METHODS This study is based a sub-cohort of the Lifelines general population cohort that repeatedly completed questionnaires during the COVID-19 pandemic. PCC was defined based on increased post-COVID-19 symptom scores compared to individuals' pre-infection symptom scores. Three groups were identified in the cohort: COVID-19 positive participants with PCC (PCC group), COVID-19 positive participants without PCC (COVID-19 group), and COVID-19 negative participants (control group). HCRU in the past three months was assessed in four waves of questionnaires (from June 2021 to June 2022). Self-reported frequencies of resource use in primary, secondary, and emergency care as well as hours of homecare and informal care received were calculated as an annual per person rate. Associated costs were calculated per person, using standard unit prices in 2022 Euros. RESULTS HCRU was highest in the PCC group for almost all types of healthcare. Relative differences between PCC and control participants were highest for the hours of nursing care at home received, occupational and speech therapist consultations, day treatments at a rehabilitation center, and occupational physician visits. Total average annual healthcare costs per person were estimated at €1,136, €616, and €678 for the PCC, COVID-19 and control group, respectively. CONCLUSION PCC is associated with a substantial increase in HCRU and associated costs in healthcare and society as a whole. The results may guide health authorities in planning for public health emergency preparedness.