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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2025-01-01
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Online Access: | https://doi.org/10.1371/journal.pone.0314164 |
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author | Afschin Gandjour |
author_facet | Afschin Gandjour |
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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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institution | Kabale University |
issn | 1932-6203 |
language | English |
publishDate | 2025-01-01 |
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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 |
work_keys_str_mv | AT afschingandjour healtheconomicevaluationoftheoutpatientinpatientandpublichealthsectoringermanyinsightsfromthefirstthreecovid19waves |