Abstract
BackgroundCommunity Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France.MethodsA total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae was confirmed by microbiological sampling. Quality of life was reported at four different points of time with the EQ-5D-3 L health states using the French reference tariff. Complete data on all four periods was available for 269 patients.We used descriptive and econometric analysis to assess quality of life over time during follow-up, and to identify factors that impact the utility indexes and their evolution through time. We used Tobit panel data estimators to deal with the bounded nature of utility values.ResultsAverage age of patients was 63 and 55% of patients were men. Negative predictors of quality of life were the severity of the initial event, history of pneumonia, smokers, age and being male. On average, quality of life improved in the first 6 months after discharge and stabilized beyond. At month 1, mean utility index was 0.53 (SD: 0.34) for men and 0.45 (SD: 0.34) for women, versus mean of 0.69 (SD: 0.33) and 0.70 (SD: 0.35) at Month 12. “Usual activities” was the dimension the most impacted by the disease episode. Utilities for men were significantly higher than for women, although male patients were more severe. Individuals over 85 years old did not improve quality of life during follow-up, and quality of life did not improve or deteriorated for 34% of patients. We found that length of hospital stay was negatively correlated with quality of life immediately after discharge.ConclusionThis study provides with evidence that quality of life after an episode of community acquired pneumococcal pneumonia improves overall until the sixth month after hospital discharge, but older patients with previous history of pneumonia may not experience health gains after the initial episode.
Highlights
Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death
This study provides with data on health states and utility indexes after hospital discharge and over a year in individuals who were hospitalized for a Community Acquired Pneumococcal Pneumonia (CAPP)
Around one fifth of patients had had a previous history of pneumonia and 55% were recorded as having a Port index of 4 or 5, which scores a severe pneumonia
Summary
Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France. Community acquired pneumonia (CAP) is a lung infection that still remains associated with considerable mortality and morbidity. Probability of hospital admission is high for patients with CAP, putting a high strain on health resources. Because of the huge impact on heath costs and patients’ quality of life, the management of CAP is a challenge issue [1, 2]. There have being a growing number of studies focusing on patients’ perspective to assess the outcomes of health interventions. A measure commonly used in utility analysis is the quality-adjusted life year (QALYs). The QALY metric requires a descriptive system of health states, reflecting differences in health related quality of life, and a preference-based valuation system allocating a single index to each of them [3, 4]
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