{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T20:03:33Z","timestamp":1785096213463,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Information on the costs of inpatient care for patients with coronavirus disease 2019 (COVID-19) is very limited. This study estimates the per-patient cost of inpatient care for adult COVID-19 patients seen at &amp;gt;800 US hospitals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients aged \u226518 years with \u22651 hospitalization during March 2020\u2013July 2021 with a COVID-19 diagnosis code in a large electronic administrative discharge database were included. We used validated costs when reported; otherwise, costs were calculated using charges multiplied by cost-to-charge ratios. We estimated costs of inpatient care per patient overall and by severity indicator, age, sex, underlying medical conditions, and acute complications of COVID-19 using a generalized linear model with log link function and gamma distribution.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The overall cost among 654673 patients hospitalized with COVID-19 was $16.2 billion. Estimated per-patient hospitalization cost was $24 826. Among surviving patients, estimated per-patient cost was $13 090 without intensive care unit (ICU) admission or invasive mechanical ventilation (IMV), $21 222 with ICU admission alone, and $59 742 with IMV. Estimated per-patient cost among patients who died was $27 017. Adjusted cost differential was higher among patients with certain underlying conditions (eg, chronic kidney disease [$12 391], liver disease [$8878], cerebrovascular disease [$7267], and obesity [$5933]) and acute complications (eg, acute respiratory distress syndrome [$43 912], pneumothorax [$25 240], and intracranial hemorrhage [$22 280]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The cost of inpatient care for COVID-19 patients was substantial through the first 17 months of the pandemic. These estimates can be used to inform policy makers and planners and cost-effectiveness analysis of public health interventions to alleviate the burden of COVID-19.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofab561","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T15:04:24Z","timestamp":1640012664000},"source":"Crossref","is-referenced-by-count":27,"title":["Estimation of Coronavirus Disease 2019 Hospitalization Costs From a Large Electronic Administrative Discharge Database, March 2020\u2013July 2021"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6984-3522","authenticated-orcid":false,"given":"Sundar S","family":"Shrestha","sequence":"first","affiliation":[{"name":"Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyudmyla","family":"Kompaniyets","sequence":"additional","affiliation":[{"name":"Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D","family":"Grosse","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M","family":"Harris","sequence":"additional","affiliation":[{"name":"Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Baggs","sequence":"additional","affiliation":[{"name":"Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanta","family":"Sircar","sequence":"additional","affiliation":[{"name":"Division of Environmental Health Science and Practice. Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adi V","family":"Gundlapalli","sequence":"additional","affiliation":[{"name":"Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,20]]},"reference":[{"key":"2021122015033255900_CIT0001","volume-title":"COVID data tracker. Demographic trends of COVID-19 cases and deaths in the U.S. reported to CDC","author":"Centers for Disease Control and Prevention."},{"key":"2021122015033255900_CIT0002","author":"Centers for Disease Control and Prevention."},{"key":"2021122015033255900_CIT0003","author":"Johns Hopkins University and Medicine. Corona Virus Resource Center."},{"key":"2021122015033255900_CIT0004","author":"Centers for Disease Control and Prevention."},{"key":"2021122015033255900_CIT0005","doi-asserted-by":"crossref","first-page":"523","DOI":"10.15585\/mmwr.mm7014e2","article-title":"Death certificate\u2013based ICD-10 diagnosis codes for COVID-19 mortality surveillance \u2014 United States, January\u2013December 2020.","volume":"70","author":"Gundlapalli","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021122015033255900_CIT0006","author":"Johns Hopkins University and Medicine. Coronavirus Resource Center."},{"key":"2021122015033255900_CIT0007","doi-asserted-by":"crossref","first-page":"355","DOI":"10.15585\/mmwr.mm7010e4","article-title":"Body mass index and risk for COVID-19\u2013related hospitalization, intensive care unit admission, invasive mechanical ventilation, and death \u2014 United States, March\u2013December 2020.","volume":"70","author":"Kompaniyets","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021122015033255900_CIT0008","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.15585\/mmwr.mm6945e2","article-title":"Characteristics of hospitalized COVID-19 patients discharged and experiencing same-hospital readmission - United States, March-August 2020.","volume":"69","author":"Lavery","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021122015033255900_CIT0009","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1377\/hlthaff.2020.00426","article-title":"The potential health care costs and resource use associated with COVID-19 in the United States.","volume":"39","author":"Bartsch","year":"2020","journal-title":"Health Aff (Millwood)"},{"key":"2021122015033255900_CIT0010","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1001\/jama.2020.19759","article-title":"The COVID-19 pandemic and the $16 trillion virus.","volume":"324","author":"Cutler","year":"2020","journal-title":"JAMA"},{"key":"2021122015033255900_CIT0011","author":"FAIR Health."},{"key":"2021122015033255900_CIT0012","doi-asserted-by":"crossref","first-page":"723","DOI":"10.2147\/CEOR.S280461","article-title":"Incremental costs associated with length of hospitalization due to viral pneumonia: impact of intensive care and economic implications of reducing the length of stay in the era of COVID-19.","volume":"12","author":"Wu","year":"2020","journal-title":"Clinicoecon Outcomes Res"},{"key":"2021122015033255900_CIT0013","author":"Centers for Medicare and Medicaid Services."},{"key":"2021122015033255900_CIT0014","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.7326\/M21-1102","article-title":"Patient characteristics and costs associated with COVID-19-related medical care among Medicare fee-for-service beneficiaries.","volume":"174","author":"Tsai","year":"2021","journal-title":"Ann Intern Med"},{"key":"2021122015033255900_CIT0015","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1080\/13696998.2021.1886109","article-title":"Health outcomes and economic burden of hospitalized COVID-19 patients in the United States.","volume":"24","author":"Di Fusco","year":"2021","journal-title":"J Med Econ"},{"key":"2021122015033255900_CIT0016","author":"Premier."},{"key":"2021122015033255900_CIT0017","doi-asserted-by":"crossref","first-page":"2553","DOI":"10.1001\/jama.2020.20323","article-title":"Uptake and accuracy of the diagnosis code for COVID-19 among US Hospitalizations.","volume":"324","author":"Kadri","year":"2020","journal-title":"JAMA"},{"key":"2021122015033255900_CIT0018","author":"Centers for Disease Control and Prevention."},{"key":"2021122015033255900_CIT0019","author":"Centers for Disease Control and Prevention."},{"key":"2021122015033255900_CIT0020","doi-asserted-by":"crossref","first-page":"e201323","DOI":"10.1001\/jamanetworkopen.2020.1323","article-title":"Respiratory and nonrespiratory diagnoses associated with influenza in hospitalized adults.","volume":"3","author":"Chow","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2021122015033255900_CIT0021","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1111\/1475-6773.12612","article-title":"Adjusting health expenditures for inflation: a review of measures for health services research in the United States.","volume":"53","author":"Dunn","year":"2018","journal-title":"Health Serv Res"},{"key":"2021122015033255900_CIT0022","doi-asserted-by":"crossref","first-page":"ofaa638","DOI":"10.1093\/ofid\/ofaa638","article-title":"Risk of clinical severity by age and race\/ethnicity among adults hospitalized for COVID-19-United States, March-September 2020.","volume":"8","author":"Pennington","year":"2021","journal-title":"Open Forum Infect Dis"},{"key":"2021122015033255900_CIT0023","author":"Centers for Disease Control and Prevention."},{"key":"2021122015033255900_CIT0024","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.15585\/mmwr.mm6942e3","article-title":"Risk for in-hospital complications associated with COVID-19 and influenza - Veterans Health Administration, United States, October 1, 2018-May 31, 2020.","volume":"69","author":"Cates","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021122015033255900_CIT0025","first-page":"1","article-title":"Racial and ethnic disparities in hospital admissions from COVID-19: determining the impact of neighborhood deprivation and primary language.","volume":"18","author":"Ingraham","year":"2021","journal-title":"J Gen Intern Med"},{"key":"2021122015033255900_CIT0026","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1377\/hlthaff.2020.00598","article-title":"Disparities in outcomes among COVID-19 patients in a large health care system in California.","volume":"39","author":"Azar","year":"2021","journal-title":"Health Affairs"},{"key":"2021122015033255900_CIT0027","doi-asserted-by":"crossref","first-page":"e206","DOI":"10.1093\/cid\/ciaa1012","article-title":"Risk factors for intensive care unit admission and in-hospital mortality among hospitalized adults identified through the US Coronavirus Disease 2019 (COVID-19)-Associated Hospitalization Surveillance Network (COVID-NET).","volume":"72","author":"Kim","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2021122015033255900_CIT0028","doi-asserted-by":"crossref","first-page":"2534","DOI":"10.1056\/NEJMsa2011686","article-title":"Hospitalization and mortality among black patients and white patients with Covid-19.","volume":"382","author":"Price-Haywood","year":"2020","journal-title":"N Engl J Med"},{"key":"2021122015033255900_CIT0029","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jnma.2020.07.009","article-title":"National disparities in COVID-19 outcomes between black and white Americans.","volume":"113","author":"Poulson","year":"2021","journal-title":"J Natl Med Assoc"},{"key":"2021122015033255900_CIT0030","doi-asserted-by":"crossref","first-page":"e1003321","DOI":"10.1371\/journal.pmed.1003321","article-title":"Comorbidities associated with mortality in 31,461 adults with COVID-19 in the United States: a federated electronic medical record analysis.","volume":"17","author":"Harrison","year":"2020","journal-title":"PLoS Med"},{"key":"2021122015033255900_CIT0031","doi-asserted-by":"crossref","first-page":"e237","DOI":"10.3346\/jkms.2020.35.e237","article-title":"Effect of underlying comorbidities on the infection and severity of COVID-19 in Korea: a nationwide case-control study.","volume":"35","author":"Ji","year":"2020","journal-title":"J Korean Med Sci"},{"key":"2021122015033255900_CIT0032","doi-asserted-by":"crossref","first-page":"e2012270","DOI":"10.1001\/jamanetworkopen.2020.12270","article-title":"Clinical characteristics and morbidity associated with coronavirus disease 2019 in a series of patients in metropolitan Detroit.","volume":"3","author":"Suleyman","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2021122015033255900_CIT0033","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1097\/MLR.0000000000000410","article-title":"Professional fee ratios for US hospital discharge data.","volume":"53","author":"Peterson","year":"2015","journal-title":"Med Care"},{"key":"2021122015033255900_CIT0034","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1001\/jamainternmed.2020.3857","article-title":"Assessment of COVID-19 hospitalizations by race\/ethnicity in 12 states.","volume":"181","author":"Karaca-Mandic","year":"2021","journal-title":"JAMA Intern Med"},{"key":"2021122015033255900_CIT0035","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1111\/j.1475-6773.2007.00822.x","article-title":"Assessing validity of ICD-9-CM and ICD-10 administrative data in recording clinical conditions in a unique dually coded database.","volume":"43","author":"Quan","year":"2008","journal-title":"Health Serv Res"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/8\/12\/ofab561\/41826186\/ofab561.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/8\/12\/ofab561\/41826186\/ofab561.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T15:04:48Z","timestamp":1640012688000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofab561\/6470753"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,1]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofab561","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,12,1]]},"published":{"date-parts":[[2021,12,1]]},"article-number":"ofab561"}}