Hospitalization budget impact during the COVID-19 pandemic in Spain

Objectives The aim was to determine the direct impact of the COVID-19 pandemic on Spain's health budget. Methods Budget impact analyses based on retrospective data from patients with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) admitted to a Spanish hospital between February 26 and May 21, 2020. Direct medical costs from the perspective of the hospital were calculated. We analyzed diagnostic tests, drugs, medical and nursing care, and isolation ward and ICU stays for three cohorts: patients seen in the emergency room only, hospitalized patients who tested positive for SARS-CoV-2, and patients who tested negative. Results The impact on the hospital's budget for the 3 months was calculated at euro15,633,180, 97.4% of which was related to health care and hospitalization. ICU stays accounted for 5.3% of the total costs. The mean cost per patient was euro10,744. The main costs were staffing costs (10,131 to 11,357 euro/patient for physicians and 10,274 to 11,215 euro/patient for nurses). Scenario analysis showed that the range of hospital expenditure was between euro14,693,256 and euro16,524,924. The median impact of the pandemic on the Spanish health budget in the sensitivity analysis using bootstrapped individual data was euro9357 million (interquartile range [IQR], 9071 to 9689) for the conservative scenario (113,588 hospital admissions and 11,664 ICU admissions) and euro10,385 million (IQR, 110,030 to 10,758) for the worst-case scenario (including suspected cases). Conclusion The impact of COVID-19 on the Spanish public health budget (12.3% of total public health expenditure) is greater than multiple sclerosis, cancer and diabetes cost.