OBJECTIVES: Neuromyelitis Optica Spectrum Disorder (NMOSD) is an autoimmune disease more prevalent among female and non-white patients. While several studies highlight the societal burden of NMOSD, limited research evaluate the impact of sociodemographic factors on NMOSD hospitalizations. This study compares NMOSD hospitalizations with overall hospitalizations and assess the impact of sociodemographic factors.

METHODS: We used the Healthcare Cost and Utilization Project (HCUP) data from 2016 – 2020 and identified NMOSD cases (ICD10: G36.0). Sociodemographic factors, hospital characteristics, and outcomes were pooled for analyses. Multivariate analyses were adjusted for income, region, procedures, and hospital characteristics.

RESULTS: We identified 1,686 NMOSD hospitalizations and patients were, on average, 44.9 ±15.4 years old and predominantly female (79.5%). Compared to the national HCUP average, NMOSD length of stay (LOS) (8.0 ±7.3 days), was longer (HCUP: 4.8 ±6.5 days) and total charges ($84,171 ±74,294) were also higher (HCUP: $57,419 ±96,851). Black patients accounted for 39.6% NMOSD hospitalizations, higher than their representation in HCUP and the US population; White (37.3%) and Hispanic (11.9%) patient hospitalizations were less common. Black patients had an average LOS of 8.6 ±7.6 days, higher compared to White (7.3 ±7.3 days) and Hispanic (7.6 ±6.1days) patients. Hispanic patients incurred the highest total charges ($98,501 ±85,871) followed by Black ($81,404 ±72,857) and White ($80,089 ±73,396) patients. A multivariate regression analysis of LOS and total charges against sociodemographic and hospital characteristics revealed being Black was associated with an increased LOS of 1.3 days (p-value < 0.01) and being Hispanic was associated with a 16.8% increase in total charges (p-value < 0.01) compared to their White counterparts.

CONCLUSIONS: NMOSD hospitalizations were almost twice as long and more expensive compared to national hospitalizations. Black patients had substantially longer LOS and Hispanic patients incurred significantly higher charges. Effective management of NMOSD is crucial to prevent hospitalizations and ensure better patient outcomes.