Cost and Length of Stay for Department of Defense Hospitalizations Attributed to COVID-for Adults with Diabetes

ABSTRACT

Healthcare costs in 2020 increased 9.7% from the prior year reaching $4.1 trillion dollars. This increase is considered largely due to the COVID-pandemic. Since adults with diabetes were at increased risk of poor outcomes from COVID-19, the objective of this study was to investigate cost and length of stay for Department of Defense (DoD) hospitalizations attributed to COVID-for adults with diabetes. Data on hospitalizations within military facilities between 2020-2021 for patients with diabetes were investigated. 6,265 hospitalizations occurred at DoD facilities, of which 7.2% (n=458) were attributed to COVID-19. Generalized linear models using a gamma distribution for total cost and Poisson distribution for length of stay were run to investigate outcomes adjusting for age, sex, race/ethnicity, active duty status, service category (Army, Coast Guard, Marine, Air Force, or Navy) , and comorbidity count. In adults with diabetes hospitalized at military facilities, those with COVID-cost over $8,500 more than those without COVID- (8792.98, 95%CI 5850.38,11735.57) after adjustment. There were no significant differences by sex or race/ethnicity, however, active duty hospitalizations cost on average $2,200 more than not active duty (2239.26, 95%CI 738.72,3739.81) . Length of stay was over 2 days longer for COVID-hospitalizations (2.20, 95%CI 1.98,2.42) after adjustment. There were no differences by sex, however African Americans and Asian/Pacific Islanders had slightly longer lengths of stay (AA 0.37, 95%CI 0.26,0.48;A/PI 0.26, 95%CI 0.05,0.46) , as did those on active duty (0.24, 95%CI 0.08,0.40) . Total costs for hospitalizations attributed to COVID-were higher and length of stay longer for adults with diabetes at military facilities. Further work is needed to understand long term consequences of COVID-on cost and utilization for adults with diabetes.