Cardiovascular Hospitalizations and Hospitalization Costs in Japan During the COVID-19 Pandemic

Tadafumi Sugimoto; Atsushi Mizuno; Daisuke Yoneoka; Shingo Matsumoto; Chisa Matsumoto; Yuya Matsue; Mari Ishida; Michikazu Nakai; Yoshitaka Iwanaga; Yoshihiro Miyamoto; Koichi Node

doi:10.1253/circrep.CR-23-0072

Cardiovascular Hospitalizations and Hospitalization Costs in Japan During the COVID-19 Pandemic

Circ Rep. 2023 Sep 16;5(10):381-391. doi: 10.1253/circrep.CR-23-0072. eCollection 2023 Oct 10.

Authors

Tadafumi Sugimoto^{1

2

3}, Atsushi Mizuno^{3

4

5

6}, Daisuke Yoneoka⁷, Shingo Matsumoto⁸, Chisa Matsumoto^{3

9}, Yuya Matsue¹⁰, Mari Ishida^{3

11}, Michikazu Nakai^{12

13}, Yoshitaka Iwanaga^{12

14}, Yoshihiro Miyamoto^{12

15}, Koichi Node^{3

16}

Affiliations

¹ Department of Cardiology, Nagoya City University Mirai Kousei Hospital Nagoya Japan.
² Department of Cardiology and Nephrology, Mie University Graduate School of Medicine Tsu Japan.
³ Information and Communication Committee, The Japanese Circulation Society Tokyo Japan.
⁴ Department of Cardiovascular Medicine, St. Luke's International Hospital Tokyo Japan.
⁵ Penn Medicine Nudge Unit, University of Pennsylvania Philadelphia, PA USA.
⁶ Leonard Davis Institute for Health Economics, University of Pennsylvania Philadelphia, PA USA.
⁷ Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases Tokyo Japan.
⁸ Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine Tokyo Japan.
⁹ Department of Cardiology, Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Tokyo Japan.
¹⁰ Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine Tokyo Japan.
¹¹ Department of Cardiovascular Physiology and Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University Hiroshima Japan.
¹² Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center Suita Japan.
¹³ Clinical Research Support Center, University of Miyazaki Hospital Miyazaki Japan.
¹⁴ Department of Cardiology, Sakurabashi-Watanabe Hospital Osaka Japan.
¹⁵ Open Innovation Center, National Cerebral and Cardiovascular Center Suita Japan.
¹⁶ Department of Cardiovascular Medicine, Saga University Saga Japan.

Abstract

Background: During the COVID-19 pandemic, cardiovascular hospitalizations decreased and in-hospital mortality for ST-elevation myocardial infarction and heart failure increased. However, limited research has been conducted on hospitalization and mortality rates for cardiovascular disease (CVD) other than ischemic heart disease and heart failure. Methods and Results: We analyzed the records of 530 certified hospitals affiliated with the Japanese Circulation Society obtained from the nationwide JROAD-DPC database between April 2014 and March 2021. A quasi-Poisson regression model was used to predict the counterfactual number of hospitalizations for CVD treatment, assuming there was no pandemic. The observed number of inpatients compared with the predicted number in 2020 was 88.1% for acute CVD, 78% for surgeries or procedures, 77.2% for catheter ablation, and 68.5% for left ventricular assist devices. Furthermore, there was no significant change in in-hospital mortality, and the decrease in hospitalizations for catheter ablation and valvular heart disease constituted 47.6% of the total decrease in annual hospitalization costs during the COVID-19 pandemic. Conclusions: Cardiovascular hospitalizations decreased by more than 10% in 2020, and the number of patients scheduled for left ventricular assist device implantation decreased by over 30%. In addition, in response to the COVID-19 pandemic, annual cardiovascular hospitalization costs were reduced, largely attributed to decreased catheter ablation and valvular heart disease.

Keywords: COVID-19; Cardiovascular disease; Hospitalizations; JROAD-DPC.