Illumicare has the unique opportunity to analyse patient care by processing real-time EMR data feeds and assigning the wholesale cost of every order for a medication, lab, and radiology test. We have evaluated data of over 40,000 inpatient COVID-19 patients from nine hospital systems representing different regions of the United States. We utilized the test results of in-house COVID-19 tests and patient ICD Codes to determine the COVID status of a patient. Our goal of this analysis is to visualize and understand how physician-controlled costs and length of stay has changed over the course of the COVID-19 pandemic, for both COVID positive and negative patients.
COVID positive patient costs will be evaluated in two ways in this report, in terms of "Total Cost" and "Filtered Cost". "Total Cost" is the average cost per patient per month while the "Filtered Cost" is the average cost excluding Remdesivir, the primary drug used in the treatment of COVID-19. This drug is critical for patient care but is highly expensive at $520 per dose, quickly becoming the greatest price driver in care of COVID positive patients.
Average length of stay (ALOS) is a common statistic of evaluating hospital efficiency and cost. An increase in length of stay results in increased hospital costs, both in labor and physician-controlled costs, as well as patient dissatifaction and a greater chance of readmission.
In Figure 1, we observe that the ALOS of COVID negative patients has remained relatively consistent during the pandemic, despite variation in hospital admission rates and policies on surgical procedures. We do, however, notice a significant decrease in ALOS of COVID patients. Patients admitted in March 2020, the first month of the pandemic, stayed an average of 12.06 days while those admitted in January 2021 stayed an average of 7.92 days, a 34% reduction.
Illumicare is uniquely able to determine a patient's cost using wholesale costs instead of utilizing charge codes. This gives us the ability to determine the financial impact physicians' care decisions have on the hospital and on the patient. In figure 2, we again see that providers were able to keep care of COVID negative relatively stable during the pandemic, even reducing the cost per patient.
In COVID positive patients, the total average monthly cost appears to fluctuate but remains relatively stagnant as viewed in the "Total Cost" tab. When filtering out the cost of Remdesivir, we see that the average cost of a COVID positive patient has fallen dramatically from $4,474 to $2,051, an over 50% reduction.
Cost per patient day is calculated as the sum total spend on patients divided the sum total number of patient stay days. Cost per patient day controls for noise in cost change due to patient length of stay variance, and shows whether a provider's daily activity is becoming more or less efficient.
The cost per patient day has steadily increased as Remdesivir has become more readily available and utilized, however, filtering out Remdesivir reveals that the average of all other physician-controlled costs are steadily decreasing per patient day.
To further break down the cost of COVID-19 positive patients, we have broken out the cost of medication orders, lab tests, and radiology tests. Total average cost of meds rose due to the introduction of Remdesivir, but has fallen 54.7% when excluding the cost of Remdesivir. Additionally, lab spend has fallen 59.3%, or over $750.00 per patient.
To explore the utilization of individual drugs over time, the following treemap indicates the ordering magnitude and cost change of drugs, grouped by drug group and drug name. Size indicates the number of COVID-19 patients treated with the drug, while color indicates the slope of the regressed trend in spend per hospitalization. Red indicates that spend in increasing, green indicates that spend is decreasing, and white indicates stagnation. Hover over a square for further detail.
A searchable summary of the Medications Map