Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves.

<h4>Aim</h4>The aim of this study is to quantify the effectiveness and cost-effectiveness of the outpatient and inpatient sectors (specifically intensive care units, ICUs) and local health departments in managing the first three waves of the COVID-19 pandemic in Germany.<h4>Methods...

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Main Author: Afschin Gandjour
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0314164
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author Afschin Gandjour
author_facet Afschin Gandjour
author_sort Afschin Gandjour
collection DOAJ
description <h4>Aim</h4>The aim of this study is to quantify the effectiveness and cost-effectiveness of the outpatient and inpatient sectors (specifically intensive care units, ICUs) and local health departments in managing the first three waves of the COVID-19 pandemic in Germany.<h4>Methods</h4>The analysis is based on a modelling approach using secondary data. The effectiveness of each sector was measured by determining the reduction in the case fatality rate (CFR) of COVID-19 patients by May 7, 2021. A counterfactual scenario assuming the absence of each sector was used to quantify their effectiveness. Direct medical costs for each sector were calculated from a statutory health insurance perspective, utilizing reimbursement rates for both the inpatient and outpatient sectors. Incremental cost-effectiveness ratios (ICERs) were determined, representing the costs per death avoided.<h4>Results</h4>The ICUs achieved the greatest reduction in the CFR of COVID-19 patients during the first three waves (1.9%). The outpatient sector followed with a reduction of 1.4%, and the local health departments contributed to a 0.3% decrease in the CFR. In terms of spending, ICUs had the highest expenditures among the sectors, resulting in an ICER of €59,055 per death avoided. On the other hand, local health departments were costlier but less effective than the outpatient sector. Results remained consistent across various input assumptions.<h4>Conclusion</h4>During the first three waves of the COVID-19 pandemic in Germany, the inpatient sector (ICUs) made the largest contribution to preventing deaths while also incurring the highest costs.
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spelling doaj-art-0fd42de40b9c4974b48feb65b5f6965a2025-02-12T05:31:05ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01202e031416410.1371/journal.pone.0314164Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves.Afschin Gandjour<h4>Aim</h4>The aim of this study is to quantify the effectiveness and cost-effectiveness of the outpatient and inpatient sectors (specifically intensive care units, ICUs) and local health departments in managing the first three waves of the COVID-19 pandemic in Germany.<h4>Methods</h4>The analysis is based on a modelling approach using secondary data. The effectiveness of each sector was measured by determining the reduction in the case fatality rate (CFR) of COVID-19 patients by May 7, 2021. A counterfactual scenario assuming the absence of each sector was used to quantify their effectiveness. Direct medical costs for each sector were calculated from a statutory health insurance perspective, utilizing reimbursement rates for both the inpatient and outpatient sectors. Incremental cost-effectiveness ratios (ICERs) were determined, representing the costs per death avoided.<h4>Results</h4>The ICUs achieved the greatest reduction in the CFR of COVID-19 patients during the first three waves (1.9%). The outpatient sector followed with a reduction of 1.4%, and the local health departments contributed to a 0.3% decrease in the CFR. In terms of spending, ICUs had the highest expenditures among the sectors, resulting in an ICER of €59,055 per death avoided. On the other hand, local health departments were costlier but less effective than the outpatient sector. Results remained consistent across various input assumptions.<h4>Conclusion</h4>During the first three waves of the COVID-19 pandemic in Germany, the inpatient sector (ICUs) made the largest contribution to preventing deaths while also incurring the highest costs.https://doi.org/10.1371/journal.pone.0314164
spellingShingle Afschin Gandjour
Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves.
PLoS ONE
title Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves.
title_full Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves.
title_fullStr Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves.
title_full_unstemmed Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves.
title_short Health-economic evaluation of the outpatient, inpatient, and public health sector in Germany: Insights from the first three COVID-19 waves.
title_sort health economic evaluation of the outpatient inpatient and public health sector in germany insights from the first three covid 19 waves
url https://doi.org/10.1371/journal.pone.0314164
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