Inpatient Hospitalization Trends for COPD in 2018 versus 2021 in United States: A Retrospective Analysis
Author(s)
YUCHEN GE, MSc, Shreena Malaviya, MHS;
Cytel, Toronto, ON, Canada
Cytel, Toronto, ON, Canada
OBJECTIVES: To estimate and compare key outcomes: discharge rate, length of stay, total hospital costs and charges in patients with Chronic Obstructive Pulmonary Disease (COPD) using the latest 2021 National Inpatient Sample (NIS) post-COVID-19 versus findings from the 2018 NIS (pre-Covid-19).
METHODS: A retrospective analysis was conducted using the 2021 and 2018 NIS datasets 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. Yearly discharge, discharge per 100,000 persons, mean total cost per stay, total charge per stay and Length of Stay (LOS), along with demographic characteristics, were analyzed and compared between 2018 and 2021. Total costs and charges from 2018 USD were inflated to 2021 USD using the US Consumer Price Index (CPI) for medical care.
RESULTS: A total of 412,866 and 381,117 AECOPD hospital discharges were identified from the 2018 and 2021 NIS, respectively, reflecting a 7.7% decline. In 2021, the average cost of an inpatient stay was $20,501 vs $16,591 in 2018 whereas the average charges were $85,747 in 2021 vs $71,277 in 2018. Average LOS increased to 6.40 days in 2021, up from 5.58 days in 2018. Discharge per 100,000 persons was 126.3 in 2018, higher than 114.8 in 2021.
CONCLUSIONS: In 2021, lower discharge and discharge per 100,000 persons in COPD patients in the US during COVID-19 pandemic. However, the mean LOS increased in 2021 compared to 2018, resulting in higher mean total cost and charge per stay. Literature indicates a decline in COPD hospitalization during COVID-19 in most OECD countries and our findings confirm this trend in the US.
METHODS: A retrospective analysis was conducted using the 2021 and 2018 NIS datasets 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. Yearly discharge, discharge per 100,000 persons, mean total cost per stay, total charge per stay and Length of Stay (LOS), along with demographic characteristics, were analyzed and compared between 2018 and 2021. Total costs and charges from 2018 USD were inflated to 2021 USD using the US Consumer Price Index (CPI) for medical care.
RESULTS: A total of 412,866 and 381,117 AECOPD hospital discharges were identified from the 2018 and 2021 NIS, respectively, reflecting a 7.7% decline. In 2021, the average cost of an inpatient stay was $20,501 vs $16,591 in 2018 whereas the average charges were $85,747 in 2021 vs $71,277 in 2018. Average LOS increased to 6.40 days in 2021, up from 5.58 days in 2018. Discharge per 100,000 persons was 126.3 in 2018, higher than 114.8 in 2021.
CONCLUSIONS: In 2021, lower discharge and discharge per 100,000 persons in COPD patients in the US during COVID-19 pandemic. However, the mean LOS increased in 2021 compared to 2018, resulting in higher mean total cost and charge per stay. Literature indicates a decline in COPD hospitalization during COVID-19 in most OECD countries and our findings confirm this trend in the US.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD167
Topic
Real World Data & Information Systems
Disease
SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)