Impact of the COVID-19 pandemic on direct medical costs of acute coronary syndrome admissions in Yogyakarta, Indonesia
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Abstract
The number of admissions, therapeutic management, and clinical results of acute coronary syndrome (ACS) have been extensively reported. However, the economic impact of ACS therapy has been ignored. This study examined the effect of the COVID-19 pandemic on direct medical costs for ACS hospitalizations in Yogyakarta, Indonesia. A retrospective study of patients with ACS admitted to one of three hospitals during March to August in 2019, 2020, and 2021 was conducted. Direct medical costs from a provider’s perspective were estimated using the charges. All costs were reported in Indonesian Rupiah (IDR) at a 2021 value. Multiple linear regression analysis was used to evaluate the impact of the pandemic on total direct medical costs. The total direct medical costs associated with ACS admission per patient during the pandemic period was approximately 40% higher than that during the pre-COVID period (28.41 vs. 20.33 million IDR or 1976.90 vs. 1414.65 USD). A substantial impact of the COVID-19 pandemic on total direct medical costs still remained after adjusting the ACS types, hospital types, length of stay, percutaneous coronary intervention, in-hospital mortality, and delay time of onset to first medical contact. Given the limited health budget, reallocation of health care resources must be prioritized to maintain the provision of essential health care for those who timely treatment is crucial.
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