Avoidable intensive care unit resource use and costs of unvaccinated patients with COVID-19: a historical population-based cohort study

Purpose SARS-CoV-2 vaccines have been proven effective at preventing poor outcomes from COVID-19; however, voluntary vaccination rates have been suboptimal. We assessed the potential avoidable intensive care unit (ICU) resource use and associated costs had unvaccinated or partially vaccinated patien...

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Bibliographic Details
Published in:Canadian journal of anesthesia 2022-11, Vol.69 (11), p.1399-1404
Main Authors: Bagshaw, Sean M., Abbott, Annalise, Beesoon, Sanjay, Zuege, Danny J., Wasylak, Tracy, Manns, Braden, Nguyen, Thanh X.
Format: Article
Language:English
Subjects:
Anesthesiology
Cardiology
Cohort analysis
Cohort Studies
Coronaviruses
COVID-19
COVID-19 - prevention & control
COVID-19 Vaccines
Critical Care Medicine
Humans
Immunization
Intensive
Intensive care
Intensive Care Units
Medicine
Medicine & Public Health
Pain Medicine
Patient admissions
Pediatrics
Pneumology/Respiratory System
Population
Population-based studies
Reports of Original Investigations
Retrospective Studies
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
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Summary:Purpose SARS-CoV-2 vaccines have been proven effective at preventing poor outcomes from COVID-19; however, voluntary vaccination rates have been suboptimal. We assessed the potential avoidable intensive care unit (ICU) resource use and associated costs had unvaccinated or partially vaccinated patients hospitalized with COVID-19 been fully vaccinated. Methods We conducted a retrospective, population-based cohort study of persons aged 12 yr or greater in Alberta (2021 population ~ 4.4 million) admitted to any ICU with COVID-19 from 6 September 2021 to 4 January 2022. We used publicly available aggregate data on COVID-19 infections, vaccination status, and health services use. Intensive care unit admissions, bed-days, lengths of stay, and costs were estimated for patients with COVID-19 and stratified by vaccination status. Results In total, 1,053 patients admitted to the ICU with COVID-19 were unvaccinated, 42 were partially vaccinated, and 173 were fully vaccinated (cumulative incidence 230.6, 30.8, and 5.5 patients/100,000 population, respectively). Cumulative incidence rate ratios of ICU admission were 42.2 (95% confidence interval [CI], 39.7 to 44.9) for unvaccinated patients and 5.6 (95% CI, 4.1 to 7.6) for partially vaccinated patients when compared with fully vaccinated patients. During the study period, 1,028 avoidable ICU admissions and 13,015 bed-days were recorded for unvaccinated patients and the total avoidable costs were CAD 61.3 million. The largest opportunity to avoid ICU bed-days and costs was in unvaccinated patients aged 50 to 69 yr. Conclusions Unvaccinated patients with COVID-19 had substantially greater rates of ICU admissions, ICU bed-days, and ICU-related costs than vaccinated patients did. This increased resource use would have been potentially avoidable had these unvaccinated patients been vaccinated against SARS-CoV-2.
ISSN:0832-610X
1496-8975
DOI:10.1007/s12630-022-02299-w