# The financial burden of SARS-CoV-2 pregnancies in a tertiary exclusive COVID-19 maternity

## TL;DR

This study shows that treating pregnant women with SARS-CoV-2 in a dedicated maternity ward significantly increased healthcare costs compared to non-infected patients.

## Contribution

The study quantifies the financial impact of SARS-CoV-2 infections on healthcare costs in a specialized maternity unit.

## Key findings

- Pregnant women with SARS-CoV-2 had significantly higher medication, administrative, and investigation costs than non-infected patients.
- Severe SARS-CoV-2 cases cost about 70 times more than non-COVID-19 cases.
- Operating a dedicated COVID-19 maternity unit was found to be inefficient and highly costly.

## Abstract

The COVID-19 pandemic had a major impact on health systems worldwide, and Romania was no exception. The impact on healthcare expenses for pregnant women was considerable, especially in COVID-19-only tertiary centers. This study aimed to analyze the impact of the COVID-19 pandemic on healthcare costs in a designated COVID-19 maternity ward. We conducted an observational study comparing pregnant women with SARS-CoV-2 (study group) to those without the infection (control group). Patients were recruited at Bucur Maternity Hospital from March 2020 to March 2022. We evaluated expenses for the entire period of hospitalization, treatment, medical supplies, and medical investigations. The study included 600 pregnant women, divided equally into two groups of 300 each. Significant cost differences were observed between the COVID-19 and non-COVID-19 groups: medication costs (664.56 EUR vs. 39.49 EUR), administrative costs (191.79 EUR vs. 30.28 EUR), and medical investigation costs (191.15 EUR vs. 29.42 EUR). The costs for a severe case of COVID-19 were about two times higher than a mild case and 70 times higher than a non-COVID-19 case (P <0.001). We identified a significant cost increase due to SARS-CoV-2 infection in our unit. The expenses were augmented by the time of hospitalization, medication, and medical investigations. COVID-19 had a significant impact on healthcare costs, mostly among pregnant women with severe disease. The strategy of operating exclusively as a COVID-19 unit proved to be inefficient and highly costly to our hospital.