US Asthma Hospitalization Rates Decline, Costs Double

Asthma hospitalization rates in the United States declined from 2004 to 2017, although the inflation-adjusted hospital costs doubled in that period, according to a recent study.

Salwa S. Zghebi, PhD, of the University of Manchester, and colleagues conducted the research because asthma is a “prevalent chronic respiratory condition” that “remains a common cause for hospitalization,” but “contemporary data on asthma hospitalization rates, comorbidity burden, and in-hospital outcomes are lacking.”

Dr. Zghebi and colleagues conducted a survey-weighted analysis of hospitalizations of patients who had a primary diagnosis of asthma. They used data from the US National Inpatient Sample, finding 3,098,863 asthma admissions between 2004 and 2017. The mean patient age was 29 years, with 57% of patients being female, 36% being White, and 40% using Medicaid as the primary payer.

Asthma hospitalizations declined from 89 per 100,000 in 2004 to 56 per 100,000 in 2017, while the length of the hospitalizations “remained overall stable” during that period, according to the researchers. The median inflation-adjusted hospitalization cost was $8444 in 2004, doubling to $17,756 in 2017. Hospital costs were significantly higher for females, adults with hypertension, and adults with psychoses.

“Over time, the prevalence of mental illness increased by >50%,” Dr. Zghebi and colleagues wrote.

Patients with severe asthma or psychoses were more likely to experience prolonged hospitalization than others. Patients who were Asian/Pacific Islanders were more likely to receive ventilation than White patients.

The most common comorbidities in adults hospitalized with asthma were hypertension and diabetes, while gastroesophageal reflux disease, obstructive sleep apnea, anemia, and obesity were the most common comorbidities in children who were hospitalized.

“US asthma hospitalization rates fluctuated in earlier years but declined over time, which may reflect improvements in community care and declining asthma prevalence,” Dr. Zghebi and colleagues concluded. “Comorbidity burden, including mental illness, increased over time, and is associated with in-hospital outcomes. This highlights the changing landscape of asthma admissions, which may inform redesigning services to support prehospitalization care and help further reduce admissions, particularly among patients with multimorbidity.”

Zghebi SS, Mohamed MO, Mamas M, Kontopantelis E. Temporal trends of hospitalizations, comorbidity burden and in-hospital outcomes in patients admitted with asthma in the United States: population-based study: trends, comorbidity burden and outcomes in asthma hospitalizations. PLOS ONE. 2022.