A study published today in JAMA Network Open shows the average direct cost to provide hospital treatment for COVID-19 patients in the United States rose by 26% from 2020 to 2022, with costs increasing even after the launch of vaccination and the emergence of new variants.
Though the country has only 4% of the world's population, it saw 15% of the global hospitalizations for COVID-19 and 16.3% of deaths. Hospitalizations peaked during the winter of 2021-22, when the Omicron variant surged. At that time, 20% of US hospital admissions were for COVID-19, and almost 30% of intensive care unit (ICU) beds were used by COVID-19 patients.
Cost increase far outpaces inflation
The cross-sectional study reviewed 1,333,404 inpatient stays across the United States from March 1, 2020, through March 31, 2022. Patients had a primary or secondary COVID-19 diagnosis and were seen at 841 hospitals.
Fifty-two percent of the patients were men, with an average patient age of 59.2 years. A total of 35,909 (3%) of the patients were Asian, 181,249 (14%) Hispanic, 292,029 (22%) Black, and 788,727 (59%) White.
The mean length of stay was 8.9 days.
The adjusted mean cost of an inpatient stay was $11,275 (95% confidence interval [CI], $11,252 to $11,297) overall, increasing from $10,394 (95% CI, $10,228 to $10,559) at the end of March 2020 to $13,072 (95% CI, $12,528 to $13,617) by the end of March 2022, the authors said. That 26% increase is in significant contrast to a 2% to 5% average annual medical cost increase due to inflation.
Obesity added to costs
Certain comorbidities significantly increased the costs incurred during a patent stay, with obesity adding $2,924 on average per stay. Coagulation deficiency, or blood clotting disorders, incurred an additional $3,017 in the cost of an inpatient stay.
Treatments used during hospital stays also greatly affected costs: Notably, patients requiring extracorporeal membrane oxygenation (ECMO) had an adjusted mean cost of $36,484 (95% CI, $34,685 to $38,284).
We found that some chronic conditions resulted in significantly higher hospital costs, and it tended to be the case that those patients were more likely to use ECMO or mechanical ventilation.
Patients who used invasive mechanical ventilation had an adjusted mean cost of $20,941 (95% CI, $20,685 to $21,198) vs $9,614 (95% CI, $9,530 to $9,697) for those without this treatment. The peak use of both ECMO and mechanical ventilation was in late 2021, when 30% of COVID-19 hospitalized patients required those interventions.
"We found that some chronic conditions resulted in significantly higher hospital costs, and it tended to be the case that those patients were more likely to use ECMO or mechanical ventilation," the authors wrote. "This might suggest a higher severity of COVID-19 disease among these patients, but these higher-cost comorbidities were not consistently associated with longer lengths of stay, greater use of ICU, more comorbidities, or higher mortality rates."
Among the hospitalized patients included in the study, 13% received invasive mechanical ventilation, 27% had an ICU stay, and 13% died during their hospital stay.
