AUTHOR=Barančok Peter , Dudek Ján , Ištokovičová Petra , Kandilaki Daniela , Kotrč Michal , Löffler Ľubica , Mišík Matej , Mužik Roman , Saal Beáta , Vrbiková Martina , Zajac Rudolf , Selvek Martin , Pažitný Peter 

TITLE=The Role of COVID-19 in Excess Mortality in Slovakia: A Novel Approach Based on Healthcare Billing Records

JOURNAL=International Journal of Public Health

VOLUME=Volume 69 - 2024

YEAR=2024

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2024.1607537

DOI=10.3389/ijph.2024.1607537

ISSN=1661-8564

ABSTRACT=Objectives: Propose a methodology to identify COVID-19 associated deaths using healthcare billing records and evaluate its effectiveness by comparing the results with excess mortality data from 2020-2022 and confirmed COVID-19 deaths.Methods: A retrospective quantitative analysis was conducted by merging healthcare billing records with cause of death data. The term "COVID-19 associated death" was defined as any death occurring within a defined timeframe following a confirmed contact with COVID-19. This broader definition provides a more comprehensive measure of excess mortality compared to the officially confirmed COVID-19 deaths attributed to the virus.Results: We identified 35,399 COVID-19 associated deaths during the 3-year pandemic in Slovakia compared to 21,395 confirmed COVID-19 deaths.The identification of COVID-19 associated deaths with our methodology offers a more accurate explanation for the notably high excess mortality observed in Slovakia (31,789 deaths) during the pandemic, relative to the EU27. Additionally, healthcare billing records prove valuable in identifying these deaths at the individual patient level using claims data of health insurance companies, which is crucial for implementing targeted preventive measures and improving preparedness for future pandemics.