Direct costs of treating community-acquired pneumonia do not necessarily correlate with clinical severity

Abstract

<b>Objective:</b> Our objective was to assess the direct costs of diagnosing and treating community-acquired pneumonia (CAP), and to correlate those costs with estimated CAP severity at diagnosis. <b>Methods:</b> This was a prospective cost analysis study using bottom-up costing. Clinical severity and mortality risk were assessed on admittance of newly diagnosed patients with CAP to hospital treatment with the use of Pneumonia Severity Index (PSI) and CURB-65 scale, respectively. The sample comprised 95 inpatients, treated at Clinic for Pulmonary Diseases, Clinical Center Kragujevac, Serbia. <b>Results:</b> Expressed as mean ± standard deviation, in Euros, the direct medical costs per CAP patient were 696 ± 531. Major cost drivers, in descending order, were diagnosis and treatment of comorbidities; and administration of medications, oxygen, and blood derivatives. PSI score correlated positively with the overall frequency of use of health care services. Neither PSI nor CURB-65 score result showed any clear relationship with the direct costs of CAP treatment. <b>Conclusions:</b> Clinical severity at admission appears to be unrelated to the direct costs of CAP treatment. This is mostly attributable to unnecessary hospital admission in cases of mild pneumonia, or to extended hospital stay after clinical stability has been reached, as well as to over-prescription of antibiotics. The health authorities should put in additional efforts to improve adherence to guidelines and promote cost-effective prescribing practices and hospital care among physicians.