The COVID-19 pandemic substantially increased medical care requirements and associated costs in the older fee-for-service (FFS) Medicare beneficiary population in the USA, according to a study published in Annals of Internal Medicine.

The researchers used retrospective observational data (taken from 2020 Medicare FFS reimbursement claims) to examine the patient characteristics and direct medical costs from hospitalisations and outpatient visits associated with the COVID-19 pandemic in Medicare beneficiaries > 65 years in the District of Columbia between 1 April and 31 December 2020. Medical costs were the sum of patients' cost sharing and reimbursements for inpatient and outpatient visits.

In total, 4.2% of the 28.1 million FFS Medicare beneficiaries required COVID-19–related medical care; of these, 23% had an inpatient stay and 4.2% died during hospitalisation. More FFS Medicare beneficiaries who sought COVID-19 medical treatment were female (57%), non-Hispanic White (80%), and urban residents (77%). Total medicare FFS costs for COVID-19–related medical care were $US6.3 billion − with the vast majority (93%) for hospitalisation. Mean hospitalisation costs were $21 752 and the mean length of stay was 9.2 days; both of which increased if the patient needed a ventilator ($49 441 and 17.1 days, respectively) or died ($32 015 and 11.3 days). Outpatient visits resulted in a mean cost of $164. Patients aged ≥ 75 years were more likely to require hospitalisation, but their hospitalisation costs were lower than for younger patients. Male gender or non-White ethnicity had a higher probability of being hospitalised and incurring higher medical costs.