Presentation (CTI)

OBJECTIVES: To assess healthcare utilization in the US and compare the findings with estimates from other OECD countries (Canada, France, Germany, UK and Australia) in post-COVID-19 landscape.
METHODS: A retrospective analysis was conducted using the latest available 2021 National Inpatient Sample (NIS) from the US Nationwide Healthcare Cost and Utilization Project database. Hospital discharge records were analyzed to identify patients with primary and secondary diagnoses of acute exacerbations of Chronic Obstructive Pulmonary Disorder (AECOPD) using the International Classification of Disease (ICD-10) codes specified in the FDA AECOPD cohort algorithm. Hospital discharges and the average length of stay (LOS) for OECD countries were obtained from the OECD Healthcare Utilization database for the year 2021.
RESULTS: 381,117 AECOPD hospital discharges were identified from the 2021 NIS database, reflecting a significant decline compared to 2019 (535,951 discharges). The average patient age was 60 years, with 49.62% being female. Patients were predominantly white (67.95%), were on Medicare (52.57%), used larger hospital beds (46.33%), were treated in the south region of the US (42.33%), and generally used a private non-profit hospital (76.03%). On average, the cost of an inpatient stay was $20,500.5 (2021 USD) while the charges were $85,746.48 (2021 USD). Average LOS was 6.4 days in the US, higher than Australia (5.7 days) and lower than UK (7 days), Canada (7.9 days), France (8.1 days) and Germany (8.9 days). Discharges per 100,000 persons were 222.9 in Germany, 212.2 in Australia, 134.6 in Canada, 114.8 in US and 94.9 in France.
CONCLUSIONS: In 2021, US had the second lowest LOS compared to the other OECD countries along with lower discharge per 100,000 persons. Literature indicates a decline in COPD hospitalization during COVID-19 due to social distancing and limited healthcare capacity. Our findings support this trend while offering a comparative perspective with other OECD countries.