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Hospital costs of inpatient COVID-19 treatment increased by more than five times the overall rate of medical inflation over a 2-year period, a large cross-sectional study found.

The adjusted cost of caring for hospitalized patients with COVID-19 in the U.S. increased by 26% during the study period, compared to an average increase of 4.7% in medical care costs over the same time, reported Kandice Kapinos, PhD, of the RAND Corporation in Arlington, Virginia, and colleagues in .

"We were most surprised by the trend in costs to provide inpatient care for COVID-19 -- that they increased so much over time," Kapinos told MedPage Today. The trend was not associated with changes in case or mortality rates, the authors noted.

The direct cost of an individual hospital stay for COVID-19 treatment increased from $10,394 from March 2020 to $13,072 by March 2022, with an overall average of $11,275 per stay. Patients with some comorbidities had higher inpatient costs. For example, those with obesity or a coagulation deficiency incurred costs that were about $3,000 higher.

Researchers further analyzed data reported from August 2020 through July 15, 2023 and arrived at an aggregated direct cost to hospitals of $70 billion to provide inpatient care for COVID-19. This figure did not include outpatient treatment, testing, vaccinations, or emergency department (ED) visits that did not result in admission. The amount also did not include lost wages, lost years of productive life, or added financial burdens to families.

"As our study examined costs to provide inpatient care, our findings are particularly relevant to hospitals but also to society as we think about what the aggregate medical costs of responding to the pandemic were and how we might invest in prevention efforts for future pandemics," Kapinos told MedPage Today. "Obviously, we aren't capturing all the costs of the pandemic, but our estimate of $70 billion in inpatient costs for 2 years of the pandemic is more than double the . And it pales in comparison to [monetized] estimates of the lives lost, ."

Costs rose even as vaccination rates increased and SARS-CoV-2 variants evolved, the authors noted. The increasing use of new medical technologies over time, particularly extracorporeal membrane oxygenation (ECMO), was likely a key player in driving up hospital costs, researchers pointed out. Notably, ECMO tripled average inpatient costs, with a mean cost per stay of $36,484. Researchers also speculated that costs of COVID-19 therapeutics also increased over time as stockpiles of manufacturers' donated medications were depleted and the U.S. government scaled back financial assistance to hospitals.

The peak demand for U.S. hospital services occurred during the Omicron variant surge from November 2021 to February 2022, when patients with COVID-19 accounted for more than 20% of hospital admissions and one in three ICU admissions, the authors wrote.

The study included data from 234 teaching- and 607 community hospitals and looked at over 1.3 million inpatient stays with a primary or secondary diagnosis of COVID-19. The mean age of patients was 59.2. Approximately 60% of patients were non-Hispanic whites, 22% were Blacks, 14% were Hispanic, and 3% were Asian. A majority (81%) presented to the ED and 27% were admitted to the ICU. Thirteen percent received invasive mechanical ventilation and 13% died while in the hospital. Patients stayed on average for about 9 days.

The study analyzed hospital costs of providing care to patients, rather than amounts billed to insurers or amounts paid, because hospital costs better reflected the strain put on hospitals, the authors pointed out in a press release.

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