Impact of COVID-19 on Health Care Resource Utilization and Costs in Patients With Chronic Obstructive Pulmonary Disease and Asthma in the United States (2018–2022): A Population-Based Study

OBJECTIVES: COVID-19 disrupted healthcare use and availability. Up-to-date data on the impact of COVID-19 on chronic obstructive pulmonary disease (COPD) and asthma is needed; therefore, this study describes healthcare resource utilization (HCRU) and costs in patients with asthma and COPD before and during the COVID-19 pandemic.

METHODS: This retrospective longitudinal cohort study used the Optum Database to identify patients ≥18 years with ≥2 asthma diagnoses and patients ≥40 years with ≥2 COPD diagnoses. Patients were followed from January 2018–May 2022 or until disenrollment. Overall, COPD-related, and asthma-related (with asthma disease severity strata) HCRU and costs were captured. All analyses were descriptive.

RESULTS: Apparent decreases in all-cause and disease-related ambulatory, emergency, and hospital care were observed in patients with COPD and asthma at the beginning of the COVID-19 pandemic. From January 2018 to May 2022, the proportion of patients with COPD-related utilization ranged as follows: ambulatory visits, 14.9% to 33.0%; emergency room visits, 2.6% to 5.7%; inpatient visits, 2.3% to 4.9%. From January 2018 to May 2022, the proportion of patients with asthma-related utilization ranged as follows: ambulatory visits (severe: 14.2% to 31.6%; non-severe: 7.0% to 19.8%), emergency room visits (severe: 1.5% to 4.2%; non-severe: 0.8% to 2.0%), and inpatient visits (severe: 0.8% to 2.4%; non-severe: 0.5% to 1.2%). In contrast, telemedicine care peaked at the beginning of the pandemic, and remained elevated until May 2022. Similar to HCRU, all-cause and disease-related total healthcare costs decreased in April 2020 and appeared to gradually increase thereafter until May 2022.

CONCLUSIONS: Initially, decreases in HCRU (notably hospitalizations and emergency care), and concurrent dramatic increases in telemedicine care were observed. This population-level study describes the impact of COVID-19 on clinical and economic burden as well as disease management. These results may inform future observational studies that include pandemic-era data.