Direct Health Care Costs Associated with Asthma Hospitalizations Before and During the Covid-19 Pandemic in the United States: A Nationwide Inpatient Sample Analysis.

BackgroundAsthma, a chronic inflammatory airway disorder, can increase the risk of hospitalizations in individuals with viral infections such as COVID-19. The impact of the COVID-19 pandemic on asthma-related hospitalizations in the United States remains unknown. ObjectiveWe hypothesized that the COVID-19 pandemic led to an increase in economic burden to society and a decrease in hospitalization rates for asthma. MethodsWe analyzed weighted data from National Inpatient Sample (NIS) between January 1, 2018, and December 31, 2020. The outcomes were asthma hospitalization rates, length of stay (LOS), in-hospital mortality rates, and hospital admission costs. ResultsMore people were admitted with a primary diagnosis of asthma in 2018 and 2019 compared to 2020 (hospitalization rate per 100,000: 2018: 38.6 versus (vs) 2019:37.0 vs 2020: 21.4; P <0.001). Hospital costs increased (2018: median [IQR] 5,251 [ 3,426, 8,278]; 2019:5,677 [3,725, 8.969]; 2020: 5,881 [3,920-9,216]; P <0.001). Additionally, in-patient mortality rates slightly increased in 2020, rising to 0.44%, compared to 0.20% in 2018 and 0.30% in 2019 (P <0.001). When comparing geographic divisions, the mid-Atlantic division had the highest hospitalization rates, and the Pacific division had the highest hospitalization costs from 2018-2020 (P <0.05). ConclusionAsthma hospitalizations decreased in 2020 compared to previous years. Those admitted during the pandemic had slightly higher mortality and significantly increased hospital costs. This investigation provides valuable insights for policy makers about shifts in healthcare utilization during the pandemic.