Healthcare utilization and costs associated with S. aureus and P. aeruginosa pneumonia in the intensive care unit: a retrospective observational cohort study in a US claims database.

Moe H Kyaw,David M Kern,Judith Falloon,Siting Zhou,Hasan S Jafri,Ozgur Tunceli

doi:10.1186/s12913-015-0917-x

Moe H Kyaw, David M Kern + Show 4 more

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https://doi.org/10.1186/s12913-015-0917-x

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Abstract

BackgroundStaphylococcus aureus and Pseudomonas aeruginosa are major causes of pneumonia in intensive care unit (ICU) patients. Limited data exist regarding the health economic impact of S. aureus and P. aeruginosa pneumonias in the ICU setting.MethodsWe conducted a retrospective observational cohort study using a 29.6 million enrollee US medical and pharmacy administrative claims database. ICU patients with S. aureus or P. aeruginosa infection per International Classification of Diseases, 9th ed. coding between 01/01/2007-8/31/2012 were compared with ICU patients without any pneumonia or infections of interest. Primary outcomes were costs in 2012 US dollars, healthcare utilization and all-cause mortality associated with hospital-acquired S. aureus or P. aeruginosa pneumonia, and the relative odds of incurring higher costs due to a comorbid condition.ResultsPatients with S. aureus or P. aeruginosa pneumonia had longer mean hospital (37.9 or 55.4 vs 7.2 days, P < .001) and ICU stays (6.9 or 14.8 vs 1.1 days, P < .001), a higher rate of mechanical ventilation (62.6 % or 62.3 % vs 7.4 %, P < .001), higher mortality (16.0 % or 20.2 % vs 3.1 %, P < .001), and higher total mean hospitalization costs ($146,978 or $213,104 vs $33,851, P < .001) vs controls. Pneumonia survivors had significantly increased risk of rehospitalization within 30 days (27.2 % or 31.1 % vs 15.3 %, P < .001). Comorbid conditions were not associated with increased cost in the pneumonia cohorts.ConclusionsHealthcare costs and resource utilization were high among ICU patients with S. aureus or P. aeruginosa pneumonia. Reducing the incidence of these infections could lead to substantial cost savings in the United States.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-0917-x) contains supplementary material, which is available to authorized users.

Highlights

Staphylococcus aureus and Pseudomonas aeruginosa are major causes of pneumonia in intensive care unit (ICU) patients
This study assesses the impact of S. aureus or P. aeruginosa pneumonia in ICU patients on healthcare costs, utilization, and mortality both during hospitalization and subsequent to discharge from the hospital
Our findings highlight the comprehensive economic consequences attributed to S. aureus and P. aeruginosa pneumonia and can permit policy makers, payers, and healthcare providers to assess the effect of prevention or therapeutic efforts on the cost and morbidity of these ICU infections

Summary

Introduction

Staphylococcus aureus and Pseudomonas aeruginosa are major causes of pneumonia in intensive care unit (ICU) patients. Limited data exist regarding the health economic impact of S. aureus and P. aeruginosa pneumonias in the ICU setting. Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) are responsible for much of the hospital-acquired pneumonia in the United States, accounting for approximately 28 %-47%and 18 % of hospitalizations, respectively [1, 2]. S. aureus and P. aeruginosa cause 20 %-31 %. Limited data exist regarding the pharmacoeconomic and health outcomes of S. aureus and P. aeruginosa. Kyaw et al BMC Health Services Research (2015) 15:241 pneumonias in the ICU setting. This study assesses the impact of S. aureus or P. aeruginosa pneumonia in ICU patients on healthcare costs, utilization, and mortality both during hospitalization and subsequent to discharge from the hospital

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