Value-Based Care News

Hospitalization of Unvaccinated COVID-19 Patients Cost $13B

Unvaccinated COVID-19 patients may have contributed over $13 billion to the national healthcare spend from June 2021 through November 2021.

healthcare spending, coronavirus, vaccinations & immunizations

Source: Getty Images

By Kelsey Waddill

- Going without a coronavirus vaccine can have an impact on healthcare spending in the US, a Peterson-Kaiser Family Foundation Health System Tracker report on unvaccinated COVID-19 patients found.

Based on their estimates, coronavirus hospitalizations among unvaccinated patients cost $13.8 billion just in the six month timeframe from June 2021 through November 2021. 

The researchers used data from the Department of Health and Human Services (HHS) to study adults who were hospitalized and had contracted the coronavirus. CDC data on breakthrough hospitalizations helped assess how many of the hospitalizations were among unvaccinated individuals.

By subtracting the number of breakthrough cases among the already vaccinated, the researchers found that over 98 percent of coronavirus-related hospitalizations occurred among patients who were not vaccinated against the virus. 

“Although the number of vaccinated people hospitalized for COVID-19 increased in August, the number of unvaccinated people hospitalized for COVID-19 also increased, meaning that unvaccinated people still represent a similar share of total hospitalizations,” the report explained.

Other sources, however, indicated that vaccinated individuals accounted for 15 to 14 percent of coronavirus-related hospitalizations.

Given these differences, the researchers chose the most conservative estimate and calculated the cost of coronavirus hospitalizations under the assumption that 85 percent of the hospitalized cases occurred among unvaccinated patients.

After removing any individuals for whom coronavirus treatment was not the primary reason for their hospitalizations and accounting for the fact that the vaccine is not considered 100 percent efficacious, approximately 690,000 coronavirus hospitalizations occurred from June 2021 through November 2021 among the unvaccinated.

In order to assess the cost, the researchers looked at previous estimates of treatment for a single case of coronavirus. Previous research from the Peterson-Kaiser Family Foundation Health System Tracker indicated that the cost of coronavirus treatment could hit $20,000 per case, based on the cost of pneumonia treatment with complications. Other reports estimated that costs could range from nearly $17,100 to over $21,750. Cost may vary based on various factors.

With this in mind, the researchers chose to assess the cost of coronavirus cases among unvaccinated patients using the assumption that each case cost $20,000, which was under the average of the previous reports’ estimates.

The final calculation revealed that the unvaccinated patient population may have accounted fo roughly $13.8 billion in spending. The costs coincided with the surge in the Delta variant, climaxing at $4.0 billion in August 2021, with a low of $0.7 billion in June 2021.

The researchers noted that this estimate excluded the cost of outpatient care, which could hit up to $1,000 per patient.

“Though there was of course a societal cost to develop and distribute vaccinations, the vaccines save the U.S. health system money in the longer run by preventing costly hospitalizations,” the report concluded.

“In addition to preventable direct monetary costs for treatment of unvaccinated people, re-opening of schools and economic recovery also suffers as increasing COVID-19 cases continue to put Americans at risk of avoidable severe illness and even death.”

A previous analysis from the Peterson-Kaiser Family Foundation Health System found that in June and July 2021 coronavirus hospitalizations for the unvaccinated patient population cost $2.3 billion.

In April 2019, hospital spending nationwide hit $1.26 trillion and in 2018 hospital care cost $1.18 trillion, according to a report by Alatrum. 

However, in April 2021, hospital admissions and healthcare spending overall were lower than anticipated. Experts concluded that this reflected the public’s hesitancy to return to in-person healthcare during the coronavirus pandemic, along with a strained healthcare system. Coronavirus hospitalizations had a significant impact on the hospital admission rate.

Unvaccinated patients with coronavirus-related hospitalizations may soon bear more of the cost for treatment as payers renew cost-sharing for coronavirus-related hospitalizations.