SCIENTIFIC REPORT CHAPTER 1. INTRODUCTORY CHAPTER
CHAPTER 4. PATIENT SURVEY:
4.6 Financial impact
More than one in three respondents reported experiencing a financial impact of Long COVID
To the question: "Has your health condition related to long COVID (had) a financial impact on your household?” almost 58% (n=764/1 320) of respondents answered 'No', 37% (n=491/1320) answered 'Yes'; and 5%
(n=65/1320) 'Don't know'. The proportion of respondents with financial impact of COVID-19 was significantly higher among those who were hospitalised (hospitalised: 52.3% vs. not hospitalised: 34.9%, p<0.001) and among those who reported post-acute COVID-19 > 6 months (long: 47.1%, mid: 32.6%, short: 24.7%, p<0.001).
Those who experienced a financial impact of their disease were asked for which reason(s) but not all of them gave a reason. We received answers from 479 out of 491 respondents to experience a financial impact. Each of these 479 respondents gave one or several reasons. The main responses had been classified into the following broad categories: loss or lowering of income due to illness; increased medical expenses; a combination of both and direct costs related to long COVID. Loss or absence of income/employment (n=214), medical expenses (n=68) or a combination of
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both (n=56) are the main reasons reported for financial impact. More details on the financial impact of COVID-19 are presented in Box 7.
Box 7 – Main reported financial impacts of long COVID
• Loss or absence of income/employment
The main reported reason for loss of income was the fact that respondents had been ill and received a health insurance benefit (n=71) which is lower than their full salary and also implies a loss of additional benefits (e.g. loss of meal vouchers).
‘Ik leef nu op een uitkering van het ziekenfonds. Dat is ongeveer 1/3 van mijn normaal netto loon’
‘Pas de chèque repas, impact sur mon plan cafétéria’
When returning back to work several respondents reported that they were not able to start full-time straight away. Respondents reported that they had returned to work part-time, which also reduced their income.
‘J’ai travaillé à mi-temps pendant 8 mois parce qu'il était impossible physiquement et mentalement de travailler à temps plein à cause des symptômes invalidants du COVID long’
‘Loss income included people without rights to social security benefits, those who lost their job due to illness or those who was already unemployed which have a higher financial impact of their condition.’
‘Contrat CDD non renouvelé car beaucoup d'absence sur plusieurs mois... Pas de compréhension de la part de l'employeur.’
‘Job verloren wegens tijdelijk contract niet te verlengen.’
‘Heb moeten leven van een minimale OCMW uitkering ( had geen jaar gewerkt dus geen recht op)’
• Work Incapacity
A distinction was made between respondents who mentioned an incapacity for work and the payment of compensation (these patients were categorised in the loss of income category) and the respondents who mentioned an incapacity for work without financial compensation.
‘Je ne sais plus travailler beaucoup, trop vite épuisé’
‘Ik heb door deze COVID-infectie al maanden (> 6 maanden) mijn werk niet kunnen hervatten.’
For some respondents, the loss income was not limited to themselves. Several respondents reported that their absence of work coincided with income loss of their partners who were ill at the same time. Other stated that after being absent of work due to illness they also had to take additional time off to care for their relatives who were off sick.
‘Ik krijg sinds begin juni een ziekte uitkering. Dit is minder dan mijn loon, (…). Mijn man heeft dit ook, dus het gaat om veel geld elke maand’
‘Mon mari a dû prendre congé sans soldes pour s'occuper des 4 enfants pendant 4 semaines.’
There are contradictory statements from respondents with self-employed status. Some of them (n=12), specifically mentioned a loss of income due to the payment of indemnities.
‘Étant indépendante, j'ai touché le minimum.’
‘Als zelfstandige krijg je per maand iets meer dan 1000,00€.’
Other respondents with self-employed status indicated that they had no income.
‘Pas de revenus car indépendante’
‘Als zelfstandige heeft de zaak moeten sluiten, dus geen inkomen’
• Medical expenses
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The reported financial impact related to medical expenses mainly concerned (n=48/68) reimbursed services related to medical examinations, consultations with the general practitioner and/or specialist(s) and hospitalisation. In this case, the financial difficulty related to the fact that having to make an advance payment before being reimbursed and to the multiplicity of health professionals consulted to get a diagnosis. Yet the reported financial impact also concerns expenses for services that are not or only partly reimbursed (e.g. consultations with psychologist), alternative therapies (n=20) and non-reimbursed products (e.g. vitamin supplements).
‘Tous ces rendez-vous médicaux chez divers spécialistes, les prises de sang et autres analyses, les séances kinés et psy... ont quand même constitué un sacré budget sur les 8 derniers mois.’
‘Kosten hospitaal €14 7000. Vrouw opgenomen gedurende een maand op neurologie. Door weerbots feit van mijn ziekte €40 000 kosten kine, psychiater, acupunctuur personal coach €6 000 tot nu toe.’
‘Traitement via vitamines très coûteux (de l’ordre de 200€ Tous les mois et demi)’
• Combination of loss of income and increased medical expenses Some respondents clearly indicated that a combination of the above two factors was the cause of their financial difficulties.
‘Coûts d'un traitement et perte financière des revenus’
‘Kostprijs van de zorgverleners, en/of onderzoeken tijdens verlies van inkomen’
• Direct costs related to long COVID
This category concerns purchases and adaptations directly related to long COVID which are not directly medical expenses or alternative therapies. It concerns for instance the purchasing of an electric bicycle to deal with their limited physical capacity, the purchasing
of protective equipment (e.g. masks), additional household costs, and increased costs for transport (e.g. frequent medical visits.)
‘Véél hogere uitgaven aan medicatie, kine therapie, (…) mondmaskers, handschoenen, ontsmettingsproducten voor handen, kuisen’
‘Aankoop medische hulpmiddelen (krukken, wandelstok, elektrische fiets omdat gewoon fietsen niet meer lukt)’
‘Dépenses additionnelles pour aide-ménagère’
‘Tous les frais engendrés par (…) les nombreux trajets vers les hôpitaux.
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