• Michael Mazzeffi, Jonathan Curley, Paul Gallo, D Keegan Stombaugh, Joshua Roach, Nadia Lunardi, Kenan Yount, Robert Thiele, Laurent Glance, and Bhiken Naik.
• Department of Anesthesiology, University of Virginia Health, Charlottesville, Virginia. Electronic address: mmazzeff@virginia.edu.
• J. Cardiothorac. Vasc. Anesth. 2023 Aug 1; 37 (8): 144914551449-1455.

ObjectivesThe aim was to characterize hospitalization costs, charges, and lengths of hospital stay for COVID-19 patients treated with venovenous (VV) extracorporeal membrane oxygenation (ECMO) in the United States during 2020. Secondarily, differences in hospitalization costs, charges, and lengths of hospital stay were explored based on hospital-level factors.DesignRetrospective cohort study.SettingMultiple hospitals in the United States.ParticipantsAdult patients with COVID-19 who were on VV ECMO in 2020 and had data in the national inpatient sample.InterventionsNone.Measurements And Main ResultsDemographics and baseline comorbidities were recorded for patients. Primary study outcomes were hospitalization costs, charges, and lengths of hospital stay. Study outcomes were compared after stratification by hospital region, bed size, and for-profit status. The median hospitalization cost for the 3,315-patient weighted cohort was $200,300 ($99,623, $338,062). Median hospitalization charges were $870,513 ($438,228, $1,553,157), and the median length of hospital stay was 30 days (17, 46). Survival to discharge was 54.4% for all patients in the cohort. Median hospitalization cost differed by region (p = 0.01), bed size (p < 0.001), and for-profit status (p = 0.02). Median hospitalization charges also differed by region (p = 0.04), bed size (p = 0.002), and for-profit status (p < 0.001). Length of hospital stay differed by region (p = 0.03) and bed size (p < 0.001), but not for-profit status (p = 0.40). Hospitalization costs were the lowest, and charges were highest in private-for-profit hospitals. Large hospitals also had higher costs, charges, and hospital stay lengths than small hospitals.ConclusionsIn this retrospective cohort study, hospitalization costs and charges for patients with COVID-19 on VV ECMO were found to be substantial but similar to what has been reported previously for patients without COVID-19 on VV ECMO. Significant variation was observed in costs, charges, and lengths of hospital stay based on hospital-level factors.Copyright © 2023 Elsevier Inc. All rights reserved.

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