Forecasting the multidimensional burdens of hospital admissions in LRTIs and COPD: projections of healthcare expenditures, resource utilization, and socioeconomic and environmental outcomes for Switzerland

Introduction: Hospital admissions due to lower respiratory tract infections (LRTIs) and chronic obstructive pulmonary disease (COPD) represent a substantial healthcare challenge for Switzerland. Demographic shift is expected to exacerbate the burden. Thus, multidimensional projections of healthcare resource utilization, environmental, and (socio)economic impact are necessary to facilitate sustainable healthcare planning for these diseases.

Methods: BRONCH-2035 employed historical admissions data (2015–2023) and Swiss governmental population scenario forecasts to project nationwide hospital and intensive care unit (ICU) admissions due to LRTIs and COPD between 2025 and 2035. Projections were then leveraged to estimate future inpatient healthcare expenditures, environmental and socioeconomic burden, employing historic tariff data (SwissDRG) alongside data on disease-agnostic greenhouse gas emissions, Swiss governmental employment and Organization for Economic Co-operation and Development (OECD) economic activity.

Results: Compared to 2025, 10,055 (18.4%) additional hospitalizations and an additional 488 (14.3%) ICU admissions due to LRTI and COPD were projected for 2035, requiring 338 (21.8%) additional hospital and 7 (15.9%) surplus ICU beds. Future admissions are estimated to result in an additional 100.2 million Swiss francs (CHF) (18.3%) in inpatient healthcare expenditures and 1.3 million kg (21.1%) additional CO₂-equivalent greenhouse gas emissions. Over the period of 2025–2035, LRTI and COPD-related hospitalizations are projected to cause 2.94 million missed workdays, corresponding to 15,402 lost full-time workers, CHF 1.32 billion in productivity losses, 2.46 billion Purchasing Power Parity (PPP) in lost GDP and CHF 151 million in lost tax revenue.

Conclusions: BRONCH-2035 is the first study to project the healthcare, environmental and socioeconomic burdens in LRTI and COPD for Switzerland. Population growth and demographic shift alone are projected to exacerbate LRTI and COPD hospitalizations, ICU admissions, inpatient healthcare expenditures, and bed requirements by 2035, alongside socioeconomic and environmental consequences. These findings provide a robust baseline for healthcare planning, highlighting the need for consistent guideline-concordant prevention and structured outpatient care.