{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T12:45:57Z","timestamp":1763988357970,"version":"3.37.3"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T00:00:00Z","timestamp":1663977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T00:00:00Z","timestamp":1663977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The research council of Hamadan University of Medical Sciences","award":["9903201593"],"award-info":[{"award-number":["9903201593"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cost Eff Resour Alloc"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Accurate information on the cost determinants in the COVID-19 patients could provide policymakers a valuable planning tool for dealing with the future COVID-19 crises especially in the health systems with limited resources.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>This study aimed to determine the factors affecting direct medical cost of COVID-19 patients in Hamadan, the west of Iran.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This study considered 909 confirmed COVID-19 patients with positive real-time reverse-transcriptase polymerase-chain-reaction test which were hospitalized from 1 March to 31 January 2021 in Farshchian (Sina) hospital in Hamadan, Iran. A checklist was utilized to assess the relationship of demographic characteristics, clinical presentation, medical laboratory findings and the length of hospitalization to the direct hospitalization costs in two groups of patients (patients with hospitalization \u2264\u20099\u00a0days and &gt;\u20099\u00a0days). Statistical analysis was performed using chi-square, median test and multivariable quantile regression model at 0.05 significance levels with Stata 14 software program.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The median cost of hospitalization in patients was totally 134.48 dollars (Range: 19.19\u20132397.54) and respectively 95.87 (Range: 19.19\u2013856.63) and 507.30 dollars (Range: 68.94\u20132397.54) in patients with hospitalization \u2264\u20099\u00a0days and &gt;\u20099\u00a0days. The adjusted estimates presented that in patients with 9 or less hospitalization days history of cardiovascular disease, wheezing pulmonary lung, SPO2 lower than 90%, positive CRP, LDH higher than 942\u00a0U\/L, NA lower than 136\u00a0mEq\/L, lymphosite lower than 20% and patients with ICU experience had significantly positive relationship to the median of cost. Moreover, in patients with more than 9 hospitalization days, history of cardiovascular disease and ICU experience was statistically positive association and age older than 60\u00a0years and WBC lower than 4.5\u00a0mg\/dL had statistically negative relationship to the median of hospitalization cost.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>As the length of hospital stay, which can be associated with the severity of the disease, increases, health systems become more vulnerable in terms of resource utilization, which in turn can challenge their responsiveness and readiness to meet the specialized treatment needs of individuals.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12962-022-00386-9","type":"journal-article","created":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T17:02:53Z","timestamp":1664038973000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Which patients bring the most costs for hospital? A study on the cost determinants among COVID-19 patients in Iran"],"prefix":"10.1186","volume":"20","author":[{"given":"Vajihe","family":"Ramezani-Doroh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leili","family":"Tapak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yadollah","family":"Hamidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeid","family":"Bashirian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali Reza","family":"Soltanian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahyar","family":"Motaghed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebrahim","family":"Ghelichkhani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2610-1419","authenticated-orcid":false,"given":"Elaheh","family":"Talebi-Ghane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,24]]},"reference":[{"key":"386_CR1","unstructured":"Rohde R. Novel coronavirus (2019-nCoV) update: uncoating the virus. Am Soc Microbiol. 2020."},{"issue":"1","key":"386_CR2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12913-020-05996-8","volume":"21","author":"MG Darab","year":"2021","unstructured":"Darab MG, Keshavarz K, Sadeghi E, Shahmohamadi J, Kavosi Z. The economic burden of coronavirus disease 2019 (COVID-19): evidence from Iran. BMC Health Serv Res. 2021;21(1):1\u20137.","journal-title":"BMC Health Serv Res"},{"issue":"11","key":"386_CR3","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jama.2020.1585","volume":"323","author":"D Wang","year":"2020","unstructured":"Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061\u20139.","journal-title":"JAMA"},{"issue":"16","key":"386_CR4","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1001\/jama.2020.5394","volume":"323","author":"G Grasselli","year":"2020","unstructured":"Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574\u201381.","journal-title":"JAMA"},{"key":"386_CR5","doi-asserted-by":"publisher","DOI":"10.5812\/jhealthscope.115575","author":"E Talebi-Ghane","year":"2021","unstructured":"Talebi-Ghane E, Khazaei S, Tapak L, Soltanian AR, Bashirian S, Keramat F, et al. Potential risk factors for length of hospitalization in COVID-19 patients: a cross-sectional study. Health Scope. 2021. https:\/\/doi.org\/10.5812\/jhealthscope.115575.","journal-title":"Health Scope"},{"key":"386_CR6","first-page":"587","volume":"59","author":"AR Soltanian","year":"2021","unstructured":"Soltanian AR. Demographic and clinical features association with mortality in patients with covid-19: a cross-sectional study in the west of Iran. Acta Med Iran. 2021;59:587\u201394.","journal-title":"Acta Med Iran"},{"issue":"1","key":"386_CR7","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1080\/13696998.2021.1886109","volume":"24","author":"M Di Fusco","year":"2021","unstructured":"Di Fusco M, Shea KM, Lin J, Nguyen JL, Angulo FJ, Benigno M, et al. Health outcomes and economic burden of hospitalized COVID-19 patients in the United States. J Med Econ. 2021;24(1):308\u201317.","journal-title":"J Med Econ"},{"key":"386_CR8","doi-asserted-by":"publisher","DOI":"10.18502\/fem.v6i1.7675","author":"MH Aghajani","year":"2021","unstructured":"Aghajani MH, Sistanizad M, Toloui A, Neishaboori AM, Pourhoseingholi A, Maher A, et al. COVID-19 related hospitalization costs; assessment of influencing factors. Front Emerg Med. 2021. https:\/\/doi.org\/10.18502\/fem.v6i1.7675.","journal-title":"Front Emerg Med"},{"key":"386_CR9","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0354-2020","author":"DRQ Lemos","year":"2020","unstructured":"Lemos DRQ, D\u2019angelo SM, Farias LABG, Almeida MM, Gomes RG, Pinto GP, et al. Health system collapse 45 days after the detection of COVID-19 in Cear\u00e1, Northeast Brazil: a preliminary analysis. Rev Soc Bras Med Trop. 2020. https:\/\/doi.org\/10.1590\/0037-8682-0354-2020.","journal-title":"Rev Soc Bras Med Trop"},{"key":"386_CR10","volume":"150","author":"N Vernaz-Hegi","year":"2020","unstructured":"Vernaz-Hegi N, Agoritsas T, Calmy A, Gayet-Ageron A, Gold G, Perrier A, et al. Early experimental COVID-19 therapies: associations with length of hospital stay, mortality and related costs. Swiss Med Wkly. 2020;150: w20446.","journal-title":"Swiss Med Wkly"},{"key":"386_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100495","volume":"26","author":"AA Malik","year":"2020","unstructured":"Malik AA, McFadden SM, Elharake J, Omer SB. Determinants of COVID-19 vaccine acceptance in the US. EClinicalMedicine. 2020;26: 100495.","journal-title":"EClinicalMedicine"},{"issue":"2s","key":"386_CR12","volume":"4","author":"S Azari","year":"2020","unstructured":"Azari S, Omidi N, Arabloo J, Pourhosseini H, Rezapour A. Resource utilization and cost of hospitalized patients with COVID-19 in Iran: rationale and design of a protocol. Front Emerg Med. 2020;4(2s): e55.","journal-title":"Front Emerg Med"},{"issue":"1","key":"386_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/rmv.2146","volume":"31","author":"B Gallo Marin","year":"2021","unstructured":"Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, et al. Predictors of COVID-19 severity: a literature review. Rev Med Virol. 2021;31(1):1\u201310.","journal-title":"Rev Med Virol"},{"issue":"15","key":"386_CR14","doi-asserted-by":"publisher","first-page":"262","DOI":"10.25204\/iktisad.844714","volume":"6","author":"E Ekingen","year":"2021","unstructured":"Ekingen E, Yildiz A. COVID-19 treatment costs in Turkey: determinants and burden of the social security institution. \u0130ktisadi \u0130dari ve Siyasal Ara\u015ft\u0131rmalar Dergisi. 2021;6(15):262\u201370.","journal-title":"\u0130ktisadi \u0130dari ve Siyasal Ara\u015ft\u0131rmalar Dergisi."},{"key":"386_CR15","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-021-01887-4","author":"RL Ohsfeldt","year":"2021","unstructured":"Ohsfeldt RL, Choong CK-C, McCollam PL, Abedtash H, Kelton KA, Burge R. Inpatient hospital costs for COVID-19 patients in the United States. Adv Ther. 2021. https:\/\/doi.org\/10.1007\/s12325-021-01887-4.","journal-title":"Adv Ther"},{"key":"386_CR16","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2021.101609","author":"A Miethke-Morais","year":"2021","unstructured":"Miethke-Morais A, Cassenote A, Piva H, Tokunaga E, Cobello V, Gon\u00e7alves FAR, et al. COVID-19-related hospital cost-outcome analysis: The impact of clinical and demographic factors. Braz J Infect Dis. 2021. https:\/\/doi.org\/10.1016\/j.bjid.2021.101609.","journal-title":"Braz J Infect Dis"},{"issue":"3","key":"386_CR17","doi-asserted-by":"publisher","first-page":"1589","DOI":"10.1002\/jmv.26505","volume":"93","author":"S Taghiloo","year":"2021","unstructured":"Taghiloo S, Aliyali M, Abedi S, Mehravaran H, Sharifpour A, Zaboli E, et al. Apoptosis and immunophenotyping of peripheral blood lymphocytes in Iranian COVID-19 patients: clinical and laboratory characteristics. J Med Virol. 2021;93(3):1589\u201398.","journal-title":"J Med Virol"},{"issue":"2","key":"386_CR18","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.clim.2005.08.004","volume":"117","author":"L Marnell","year":"2005","unstructured":"Marnell L, Mold C, Du Clos TW. C-reactive protein: ligands, receptors and role in inflammation. Clin Immunol. 2005;117(2):104\u201311.","journal-title":"Clin Immunol"},{"key":"386_CR19","doi-asserted-by":"publisher","first-page":"3409","DOI":"10.2147\/IDR.S272605","volume":"13","author":"HK-A Ramadan","year":"2020","unstructured":"Ramadan HK-A, Mahmoud MA, Aburahma MZ, Elkhawaga AA, El-Mokhtar MA, Sayed IM, et al. Predictors of severity and co-infection resistance profile in COVID-19 patients: first report from upper Egypt. Infect Drug Resist. 2020;13:3409.","journal-title":"Infect Drug Resist"},{"issue":"4","key":"386_CR20","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1007\/s11739-020-02515-9","volume":"16","author":"W Hu","year":"2021","unstructured":"Hu W, Li C, Xu Y, Qi Y, Zhang Z, Li M, et al. Disorders of sodium balance and its clinical implications in COVID-19 patients: a multicenter retrospective study. Intern Emerg Med. 2021;16(4):853\u201362.","journal-title":"Intern Emerg Med"},{"issue":"8","key":"386_CR21","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1002\/cyto.a.24172","volume":"97","author":"W Huang","year":"2020","unstructured":"Huang W, Berube J, McNamara M, Saksena S, Hartman M, Arshad T, et al. Lymphocyte subset counts in COVID-19 patients: a meta-analysis. Cytometry A. 2020;97(8):772\u20136.","journal-title":"Cytometry A"},{"issue":"1","key":"386_CR22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13561-020-00298-5","volume":"11","author":"E Oksuz","year":"2021","unstructured":"Oksuz E, Malhan S, Gonen MS, Kutlubay Z, Keskindemirci Y, Tabak F. COVID-19 healthcare cost and length of hospital stay in Turkey: retrospective analysis from the first peak of the pandemic. Heal Econ Rev. 2021;11(1):1\u201312.","journal-title":"Heal Econ Rev"},{"key":"386_CR23","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.cca.2020.06.012","volume":"509","author":"E Poggiali","year":"2020","unstructured":"Poggiali E, Zaino D, Immovilli P, Rovero L, Losi G, Dacrema A, et al. Lactate dehydrogenase and C-reactive protein as predictors of respiratory failure in CoVID-19 patients. Clin Chim Acta. 2020;509:135\u20138.","journal-title":"Clin Chim Acta"}],"container-title":["Cost Effectiveness and Resource Allocation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12962-022-00386-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12962-022-00386-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12962-022-00386-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,24]],"date-time":"2022-09-24T17:09:32Z","timestamp":1664039372000},"score":1,"resource":{"primary":{"URL":"https:\/\/resource-allocation.biomedcentral.com\/articles\/10.1186\/s12962-022-00386-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,24]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["386"],"URL":"https:\/\/doi.org\/10.1186\/s12962-022-00386-9","relation":{},"ISSN":["1478-7547"],"issn-type":[{"type":"electronic","value":"1478-7547"}],"subject":[],"published":{"date-parts":[[2022,9,24]]},"assertion":[{"value":"8 December 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"We obtained approval from the Ethic Committee of Hamadan University of Medical sciences (Ethic Code: IR.UMSHA.REC.1399.268). Moreover, written informed consent was obtained from all patients or their companions.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"52"}}