Abstract In this paper, we construct interpretable zero-inflated neural network models for modeling hospital admission counts related to respiratory diseases among a health-insured population and their dependants in the United States. In particular, we exemplify our approach by considering the zero-inflated Poisson neural network (ZIPNN), and we follow the combined actuarial neural network (CANN) approach for developing zero-inflated combined actuarial neural network (ZIPCANN) models for modeling admission rates, which can accommodate the excess zero nature of admission counts data. Furthermore, we adopt the LocalGLMnet approach (Richman & Wüthrich (2023). Scandinavian Actuarial Journal, 2023(1), 71–95.) for interpreting the ZIPNN model results. This facilitates the analysis of the impact of a number of socio-demographic factors on the admission rates related to respiratory disease while benefiting from an improved predictive performance. The real-life utility of the methodologies developed as part of this work lies in the fact that they facilitate accurate rate setting, in addition to offering the potential to inform health interventions.