Hospital and ICU Admission Forecasts for LRTIS and COPD in Switzerland through 2035
Hospital and ICU Admission Forecasts for LRTIS and COPD in Switzerland through 2035: Projecting Demographic Effects on Healthcare Resource Utilisation, Inpatient Expenditures, and Greenhouse Gas Emissions (BRONCH-2035)
Thomas A. Campbell-James, MD, MPH, Desiree Schnidrig, PhD, Michel Fries, PhD, Josia D. Schramm, MSc., Noel Ackermann, MSc., Lindsay Nicholson, PhD, Patrick Beeler, MD
Value in Health, Volume 29, Issue S6
Abstract
OBJECTIVES
Lower Respiratory Tract Infections (LRTIs) and Chronic Obstructive Pulmonary Disease (COPD) are resource-intensive drivers of morbidity, mortality, economic and environmental burden in healthcare. To inform health system preparedness, BRONCH-2035 projected the impact of age-driven demographic shift on multi-dimensional outcomes associated with hospital admissions due to LRTIs and COPD in Switzerland through 2035.
METHODS
Nationwide ICD-10-coded hospital data (2015-2023) for LRTIs, COPD, and COPD with LRTI were linked to Swiss Federal Statistical Office population scenarios. Age-specific hospital and ICU admission rates were projected to 2035 and converted to bed‑days and bed utilisation using historical length‑of‑stay (LOS) and occupancy targets. Inpatient expenditures were projected using 2023 SwissDRG/ST-rehab base rates. CO₂ equivalents (CO₂e) were projected using Swiss bed/ICU‑day emission factors.
RESULTS
Between 2025 and 2035, annual hospital admissions were projected to rise from 54,786 to 64,842 (+18.4%), requiring 337 additional general ward beds (1,551 to 1,888; +21.7%) and 5 additional ICU beds (45 to 50; +11.1%), resulting in inpatient healthcare expenditure increases from CHF 546.4m to CHF 646.6m (CHF 100.2m; +18.3%). Additional hospital/ICU admissions were projected to produce 1.31m kg of CO₂e per year (6.25m to 7.56m; +21.1%). Specifically, annual LRTI admissions were projected to increase from 41,409 to 49,062 (+18.5%). COPD admissions were forecast to rise from 7,225 to 8,433 (+16.7%), while admissions due to LRTI-triggered COPD exacerbations were projected to increase from 6,153 to 7,347 (+19.4%). Retrospective regression associated smoking with longer LOS in LRTIs (Exp(β)=1.11 [95%-CI: 1.09-1.14]), LRTI-triggered COPD exacerbations (Exp(β)=1.12 [1.10-1.15]), and COPD (Exp(β)=1.12 [1.10-1.14]), alongside 30-day readmissions in COPD with/without LRTI (OR=1.33 [1.22-1.44] and OR=1.61 [1.52-1.70], respectively).
CONCLUSIONS
Demographic shift is expected to intensify LRTI- and COPD-related hospital and ICU admissions, bed utilisation, healthcare expenditures, and greenhouse gas emissions in Switzerland. Targeted prevention and structured disease management may help reduce admissions and associated outcomes, thus supporting health system resilience.