Healthcare utilisation and cost among individuals with Long COVID in England and Wales: potential value of specialised post-COVID services.

Authors

Ashkan Dashtban, Mehrdad Mizani, Yi Mu, Mamas Mamas, Evan Kontopantelis, Spiros Denaxas, Qi Huang, Kamlesh Khunti, Melissa Heightman, Rouven Priedon, Manuel Gomes, Amitava Banerjee

Published in

Journal of the Royal Society of Medicine. Pages 1410768261476537. Aug 12, 2026. Epub Aug 12, 2026.

Abstract

To compare healthcare utilisation and costs for Long COVID (LC) in England and Wales.
Case-control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID-only, no LC; (2) pre-pandemic; (3) contemporary non-COVID and (4) pre-LC (self-controlled, pre-COVID pandemic).
National, population-based, linked UK electronic health records (British Heart Foundation/NHS England Secure Data Environment).
Adults aged ⩾18 years with LC between January 2020 and December 2023.
Healthcare utilisation (number of consultations/visits per person): primary care (general practitioner (GP)), secondary care (outpatient, inpatient and emergency department, investigations and procedures) and inflation-adjusted cost (£) for LC and control populations.
In England (n = 295,180) and Wales (n = 7925), LC was associated with higher utilisation and costs across primary and secondary care. Mean annual total cost for LC versus contemporary controls was £6681.6 versus £2039.9 in Wales (3.27-fold) and £3378.3 versus £1355.8 in England (2.49-fold). GP consultations averaged 26.76 (SD 22.07) per person-year in the Welsh LC cohort versus 14.63 (SD 14.34) in England (absolute difference 12.13 visits/year). Cross-national multiplicative difference-in-differences estimates indicated a 25% greater relative LC-related cost increase in Wales compared with England (ratio 1.25, 95% CI 1.09-1.42), corresponding to an absolute excess of £2501 per person-year (95% CI £1707-£3270).
LC is associated with sustained increases in healthcare utilisation and costs in England and Wales. Our findings suggest that system-level service design may influence healthcare use and costs following COVID-19, warranting further evaluation of post-viral care models.

PMID:
42584205
Bibliographic data and abstract were imported from PubMed on 12 Aug 2026.

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