Autoimmune Disease
Hospitalization Trends and Projections of Autoimmune Diseases in the United States: A Nationwide Analysis, 2000-2030 Minkyo Song* Minkyo Song Song Song National Institute on Aging
Autoimmune diseases impose a growing healthcare burden, yet population-level evidence remains limited. We examined hospitalization trends of 28 autoimmune diseases in the U.S. using a nationally representative database, and projected rates over the next decade.
We analyzed the Nationwide Inpatient Sample, restricting analyses to autoimmune conditions with annual rates >10 per 100,000 hospitalizations. Age- and sex-standardized rates were analyzed using joinpoint regression and summarized as annual and average annual percentage changes (APC, AAPC). Hospitalization rates were projected through 2030 using ARIMA and AAPC.
We analyzed >66 million autoimmune disease-related hospitalizations. In 2022, rates ranged from 21 to 2,368 per 100,000 hospitalizations, highest for type I diabetes mellitus, inflammatory bowel disease, and rheumatic fever/rheumatic heart disease. Joinpoint analysis showed consistently increasing APC trends for 15 of 28 diseases, declining trends for one, and mixed or multi-phase patterns for the remainder. From 2000 to 2022, 25 diseases increased significantly, with the largest AAPCs observed for celiac disease (AAPC=11.1%, 95% CI: 10.6% – 12.0%), autoimmune hepatitis (10.9%, 7.5% – 14.5%), and autoimmune thyroiditis (9.1%, 8.7%-9.6%), while type 1 diabetes mellitus (−1.0%, −1.3% – −0.5%) and pernicious anemia (−3.2%, −3.5% – −2.8%) declined. Projections indicated increases for most diseases through 2030 with type 1 diabetes, inflammatory bowel disease, and rheumatoid arthritis remaining most prevalent. Trends were consistent across forecasting methods and in analyses excluding the pandemic period.
Hospitalizations for most autoimmune diseases increased over the past two decades in the U.S., reflecting a growing healthcare burden. These trends likely reflect changes in disease burden, diagnosis, and healthcare utilization. Further research is warranted to identify underlying drivers and inform prevention and health system planning.