{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:02:04Z","timestamp":1790694124012,"version":"4.1.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100007602","name":"Programme Grants for Applied Research","doi-asserted-by":"publisher","award":["COV-LT2-0043"],"award-info":[{"award-number":["COV-LT2-0043"]}],"id":[{"id":"10.13039\/501100007602","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["SP\/19\/3\/34678"],"award-info":[{"award-number":["SP\/19\/3\/34678"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J R Soc Med"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare healthcare utilisation and costs for Long COVID (LC) in England and Wales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Case\u2013control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID-only, no LC; (2) pre-pandemic; (3) contemporary non-COVID and (4) pre-LC (self-controlled, pre-COVID pandemic).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>National, population-based, linked UK electronic health records (British Heart Foundation\/NHS England Secure Data Environment).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Adults aged \u2a7e18\u2009years with LC between January 2020 and December 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures:<\/jats:title>\n                    <jats:p>Healthcare utilisation (number of consultations\/visits per person): primary care (general practitioner (GP)), secondary care (outpatient, inpatient and emergency department, investigations and procedures) and inflation-adjusted cost (\u00a3) for LC and control populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In England (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009295,180) and Wales (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20097925), LC was associated with higher utilisation and costs across primary and secondary care. Mean annual total cost for LC versus contemporary controls was \u00a36681.6 versus \u00a32039.9 in Wales (3.27-fold) and \u00a33378.3 versus \u00a31355.8 in England (2.49-fold). GP consultations averaged 26.76 (SD 22.07) per person-year in the Welsh LC cohort versus 14.63 (SD 14.34) in England (absolute difference 12.13 visits\/year). Cross-national multiplicative difference-in-differences estimates indicated a 25% greater relative LC-related cost increase in Wales compared with England (ratio 1.25, 95% CI 1.09\u20131.42), corresponding to an absolute excess of \u00a32501 per person-year (95% CI \u00a31707\u2013\u00a33270).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>LC is associated with sustained increases in healthcare utilisation and costs in England and Wales. Our findings suggest that system-level service design may influence healthcare use and costs following COVID-19, warranting further evaluation of post-viral care models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01410768261476537","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T13:41:56Z","timestamp":1786542116000},"page":"225-236","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Healthcare utilisation and cost among individuals with Long COVID in England and Wales: potential value of specialised post-COVID services"],"prefix":"10.1177","volume":"119","author":[{"given":"Ashkan","family":"Dashtban","sequence":"first","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2441-895X","authenticated-orcid":false,"given":"Mehrdad","family":"Mizani","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"},{"name":"British Heart Foundation Data Science Centre, Health Data Research UK, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Mu","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamas","family":"Mamas","sequence":"additional","affiliation":[{"name":"Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Kontopantelis","sequence":"additional","affiliation":[{"name":"Centre for Primary Care and Health Services Research, University of Manchester, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spiros","family":"Denaxas","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Huang","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[{"name":"Leicester Diabetes Centre, University of Leicester, Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Heightman","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, University College London Hospitals NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rouven","family":"Priedon","sequence":"additional","affiliation":[{"name":"British Heart Foundation Data Science Centre, Health Data Research UK, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Gomes","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology and Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8741-3411","authenticated-orcid":false,"given":"Amitava","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"},{"name":"Department of Cardiology, Barts Health NHS Trust, London, UK"},{"name":"University College London Hospitals NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/BMJ.M3026"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-086578"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp21X717449"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/S41591-021-01292-Y"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/01410768241288345"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.928996"},{"key":"e_1_3_4_8_2","unstructured":"A clinical case definition of post COVID-19 condition by a Delphi consensus 6 October 2021. See https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 (last checked 10 November 2024)."},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-64060-1"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2021-001041"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-022-00697-7"},{"key":"e_1_3_4_12_2","unstructured":"Adferiad (Recovery) Long COVID programme [HTML] | GOV.WALES. See https:\/\/www.gov.wales\/adferiad-recovery-long-covid-programme-html (last checked 11 November 2024)."},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2021.0301"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp21X717449"},{"key":"e_1_3_4_15_2","unstructured":"Abbasizanjani H Bedston S Robinson L Curds M Akbari A. 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