OBJECTIVES: The COVID-19 pandemic caused changes in patterns of healthcare resource utilization (HCRU) as the result of stay-at-home orders and other COVID-19 mitigation strategies. Reductions in air pollution were also observed during COVID-19 stay-at-home orders which may have even further impacted HCRU in patients with chronic respiratory diseases such as asthma. This study’s objective was to examine patterns of asthma-related HCRU in asthma patients during the COVID-19 pandemic.

METHODS: Asthma patients were identified in the MarketScan Commercial, Medicare, and Multi-State Medicaid Databases. Patients were required to have an inpatient claim or two outpatient claims with a diagnosis of asthma (ICD-10: J45) followed by a pharmacy claim for an inhaled corticosteroid between 1/1/2016 and 1/1/2019. Continuous enrollment was required from 1/1/2019 to 12/31/2021. Medical claims for asthma-related HCRU were identified as outpatient claims with an asthma diagnosis in any position or inpatient claims with an asthma diagnosis in the primary position. Asthma-related HCRU was measured monthly in the period from 1/1/2019 to 12/31/2021; monthly HCRU in 2020 and 2021 was then compared to the same month in 2019.

RESULTS: This study included 194,684 Commercial and 183,897 Medicaid asthma patients. Mean age was 38 years (SD: 22.6) in Commercial and 19 years (SD:17.4) in Medicaid. Asthma-related emergency department (ED) visits decreased in April 2020 (57% in Commercial; 64% in Medicaid) and from 25-50% during the 2020-2021 influenza season in both populations. Decreases in asthma-related ED visits were highest in patients <18 years. Sharp decreases in asthma-related inpatient admissions also occurred in 2020 and 2021. In April 2020 inpatient admissions decreased 75% in both populations with a 55-75% reduction observed during the 2020-2021 influenza season in both populations.

CONCLUSIONS: Asthma-related HCRU decreased during the COVID-19 pandemic. These decreases may be attributable to stay-at-home orders and public health policies to mitigate COVID-19 during the 2020-2021 influenza season.