Economic Burden Of Community-acquired Pneumonia Research Articles

IJCM_103A: Cost Benefit Analysis Related to Community Acquired Pneumonia inpatients among Geriatric Age Group-A Study Conducted in A Tertiary Care Hospital

Background: Community-acquired pneumonia (CAP) is a common acute infectious disease among elderly people, and is associated with high rates of hospital admission and mortality. Old Age and male sex are known risk factors for CAP among adults and many comorbidity are also risk factors for CAP, such as chronic obstructive pulmonary disease (COPD), diabetes, cancer, dementia, congestive heart failure, and liver function failure. Objective: This study aimed to estimate the economic burden of community- acquired pneumonia (CAP) among elderly patients in Berhampur, Odisha. In addition, the study evaluated the relationship between total treatment cost and CAP risk factors. Methodology: A cross-sectional study was conducted in the IPD of MKCG MKCG Medical College of Berhampur in the period of September-November 2023. Purposive sampling was used and data was collected using semi structured questionnaire and analyzed by MS Excel 2017 Results: Among 348 are inpatient CAP episodes the mean ages were 63±8 years in outpatient group and 70±4 yrs in inpatient groups respectively. The Median treatment cost is Rs.3000/-INR per outpatient episode and Rs 10060/-INR per inpatient episode.Old patient, Male sex, Diabetes, Chronic obstructive Pulmonary Disease, liver dysfunction were associated with increased treatment cost. Conclusion: The economic burden of CAP might be decreased by reducing the number of hospitalizations for mild CAP and the incidence of severe CAP. Therefore, preventative care (e.g. oral hygiene or pneumococcus vaccination) is recommended for patients with related risk factors, such as male sex, older age, diabetes, chronic obstructive pulmonary disease.

All-cause community acquired pneumonia cost by age and risk in real-world conditions of care in Spain

ABSTRACT Background Economic burden of community-acquired pneumonia (CAP) is recognized. Few studies have documented such burden in adults stratified by age, risk status, and by care setting. Spanish data available is scarce. Method A retrospective, multicenter study in seven regions of Spain (2017–2019) was conducted. Patients ≥18 years with a primary all-cause CAP episode diagnosis were identified. Episode-level variables included risk-stratum based on presence of an immunocompromising/chronic condition, age, number and length of hospitalized and outpatient episodes, and CAP-related healthcare costs/sick leaves were included. Results 7,108 episodes [mean age (SD): 59.2 (19.6), 50.42% male, 31.0% hospitalized] were analyzed. Low-risk group accounted for 47.7% of all CAP episodes, 31.5% moderate-risk and 20.8% high-risk. Pneumococcus was identified in 42.2% of cases. Mean CAP episode length was 22.9 days for hospitalized and 13.7 days for outpatient episode. Total healthcare cost for episode was higher in inpatient vs. outpatient: €3,955 vs. €511, p < 0.001, with higher sick leave cost (€3,281 vs. €2,632, p < 0.001), respectively. Conclusion CAP required hospitalization cost is high regardless of age or comorbidities for the Spanish NHS. Given that almost half of the patients in this study did not have traditional risk factors for CAP, better preventative strategies should seriously be considered.

The 1-year economic burden of community-acquired pneumonia (CAP) initially managed in the outpatient setting in the USA.

Aim: To assess the annual economic burden of community-acquired pneumonia (CAP) initially managed in the outpatient setting. Patients & methods: Patients with an outpatient diagnosis of CAP between January 2012 and December 2016 were identified from the IQVIA (Danbury, CT&Durham, NC, USA) Real-World Data Adjudicated Claims - US Database. All-cause and CAP-related healthcare resource utilization and costs were assessed over the 1-year follow-up. Generalized linear model examined adjusted total cost. Results: Among 256,916 patients with outpatient CAP, a tenth (10.6%) had ≥1 hospitalization and, of these, 18.7% had ≥1 CAP-related hospitalization. The mean total cost per patient was US$14,372; 10.9% was CAP-related and 26.1% was due to inpatient care. The adjusted mean total all-cause cost was US$13,788. Conclusion: Patients with outpatient CAP incurred a substantial annual economic burden.

PHS79 - Relative Clinical and Economic Burden of Community Acquired Pneumonia in the Elderly

The elderly ≥ 65 years have been identified to be at higher risk for Community-Acquired Pneumonia (CAP) with higher associated morbidity and mortality. While the clinical and economic burden of CAP in this population has been extensively studied, the burden of illness has not been compared to other serious diseases. To estimate the mean length of hospital stay, in-hospital mortality, and charges/cost associated with CAP compared with myocardial infarction(MI), stroke and diabetes mellitus (DM) in hospitalized elderly patients. A retrospective analysis was conducted using the 2014 National Readmission Database. Individuals ≥ 65 years hospitalized for any of the four conditions were included in the study. Comparisons were made using chi-square and Kruskal Wallis tests. Generalized linear models was used to estimate relative risks while controlling for confounders. 2,683,665 hospitalizations representing 5,883,684 hospitalizations were analyzed. The mean age of the population was 77.1(± 7.8) years with a majority (91%) on Medicare coverage. In-hospital mortality was 1.8%, 2.0%, 1.1% and 0.4% for CAP, diabetes, MI and stroke respectively (p-value <0.0001). Adjusting for co-variates, odds of in-hospital mortality was lower in diabetes (OR: 0.36, 95%CI: 0.36-0.37) and MI (OR: 0.67, 95%CI: 0.65-0.69) compared to CAP. Median length of CAP-related hospital-stay was 5 days – which is higher compared to stroke patients (RR: 1.13, 95% CI, 1.12-1.13), but lower compared to diabetics (RR: 0.84, 95% CI, 0.83-0.84, p-value <0.001) and MI cases (RR: 0.81, 95% CI, 0.81-0.82). Median charge associated with CAP was $36,000- which is lower in CAP-cases compared to diabetes (RR: 0.87, 95% CI, 0.87-0.87), but higher compared to stroke (RR: 1.15, 95% CI, 1.15-1.15) and higher compared to MI cases. (RR: 1.01, 95% CI, 1.01-1.01). CAP is associated with significant clinical and economic burden and comparable to serious conditions like MI, stroke and diabetes mellitus.

Economic burden of community-acquired pneumonia among elderly patients: a Japanese perspective

BackgroundThis study aimed to estimate the economic burden of community-acquired pneumonia (CAP) among elderly patients in Japan. In addition, the study evaluated the relationship between total treatment cost and CAP risk factors.MethodsAn administrative database was searched for elderly patients (≥ 65 years old) who had pneumonia (ICD-10 code: J12–J18) and an antibiotic prescription between 1 June 2014 and 31 May 2015. The all-cause total healthcare costs of outpatient and inpatient CAP episodes were calculated.ResultsThis study evaluated data from 29,619 patients with CAP who experienced 14,450 outpatient CAP episodes and/or 20,314 inpatient CAP episodes. The mean ages were 77.5 ± 8.0 years and 81.5 ± 8.2 years among the outpatient and inpatient groups, respectively. The median treatment costs were US$346 (interquartile range: $195–551) per outpatient episode and US$4851 (interquartile range: $3313–7669) per inpatient episode. More severe cases had increased treatment costs at the treating hospitals. Male sex, diabetes, chronic obstructive pulmonary disease, and liver dysfunction were associated with increased total treatment costs, while dementia, dialysis, and rheumatism were associated with high costs of treating a CAP episode.ConclusionsThe economic burden of CAP might be decreased by reducing the number of hospitalizations for mild CAP and the incidence of severe CAP. Therefore, preventative care (e.g. oral hygiene or pneumococcus vaccination) is recommended for patients with related risk factors, such as male sex, older age, diabetes, chronic obstructive pulmonary disease, liver dysfunction, rheumatism, dementia, or dialysis.

Economic Burden of Community-Acquired Pneumonia Among Pediatric Patients (Aged 3 Months to < 19 Years) in the Philippines

Objective1) To determine the hospitalization, follow-up and total costs, and the economic burden of community-acquired pneumonia among pediatric patients aged 3 months to <19 years of age; 2) To compare the estimated cost of hospitalization to the pneumonia case rate payments of the Philippine Health Insurance Corporation (PhilHealth). MethodsUsing the societal perspective, both healthcare and non-healthcare costs were estimated. This was done through two tertiary private hospitals in the Philippines. A base-case and sensitivity analyses were performed using 2012 as the reference year. The PhilHealth claims were the basis for the economic burden. ResultsThe estimated healthcare-related hospitalization cost for PCAP-C was PHP24,332 – 75,409 (US$576 – 1,786). For PCAP-D, it was PHP77,460 – 121,301 (US$1,834 – 2,872) without mechanical ventilation and PHP97,993 – 141,834 if mechanical ventilation was used. These amounts are markedly higher than the PhilHealth case rates of PHP15,000 for PCAP C and PHP32,000 for PCAP D. The post-discharge cost was PHP1,175 – 1,531 for PCAP C and PHP1,275 for PCAP D. The total hospitalization cost were PHP 31,332 – 93,609 for PCAP C and PHP117,103 – 160,944 for PCAP D. The exact economic burden due to pneumonia among the pediatric population was not definitely ascertained due to lack of specific number of PhilHealth claims for this age group. ConclusionsThere is a huge disparity between the PhilHealth case rates for PCAP C and PCAP D and the study results. Hence, the estimated economic burden of hospitalization for pneumonia would be markedly higher.

PIN18 - Economic Burden of Community-Acquired Pneumonia Among Elderly

PIN18 - Economic Burden of Community-Acquired Pneumonia Among Elderly

Economic Burden of Community-Acquired Pneumonia in Adults Over 18 Years of Age

Economic Burden of Community-Acquired Pneumonia in Adults Over 18 Years of Age

Clinical and economic burden of community-acquired pneumonia in the Veterans Health Administration, 2011: a retrospective cohort study.

PurposeThe burden of community-acquired pneumonia (CAP) is not well described in the US Veterans Health Administration (VHA).MethodsCAP was defined as having a pneumonia diagnosis with evidence of chest X-ray, and no evidence of prior (90 days) hospitalization/long-term care. We calculated incidence rates of adult CAP occurring in inpatient or outpatient VHA settings in 2011. We also estimated the proportion of VHA CAP patients who were hospitalized, were readmitted within 30 days of hospital discharge, and died (any cause) in the year following diagnosis. Incremental costs during the 90 days following a CAP diagnosis were estimated from the perspective of the VHA.ResultsIn 2011, 34,101 Veterans developed CAP (35,380 episodes) over 7,739,757 VHA person-years. Median age of CAP patients was 65 years (95 % male). CAP incidence rates were higher for those aged ≥50 years. A majority of Veterans aged 50–64 (53 %) and ≥65 (66 %) years had ≥1 chronic medical (moderate risk) or immunocompromising (high risk) condition. Compared to those at low-risk (healthy), moderate- and high-risk Veterans were >3 and >6 times more likely to develop CAP, respectively. The percentage of CAP patients who were hospitalized was 45 %, ranging from 12 % (age 18–49, low risk) to 57 % (age ≥65, high risk). One-year all-cause mortality rates ranged from 1 % (age 18–49, low risk) to 36 % (age ≥65, high risk). Annual VHA medical expenditure related to CAP was estimated to be $750 million (M) ($415M for those aged ≥65 years).ConclusionA focus on CAP prevention among older Veterans and those with comorbid or immunocompromising conditions is important.Electronic supplementary materialThe online version of this article (doi:10.1007/s15010-015-0789-3) contains supplementary material, which is available to authorized users.

Economic Burden of Community-Acquired Pneumonia among Adults in the Philippines: Its Equity and Policy Implications in the Case Rate Payments of the Philippine Health Insurance Corporation

ObjectivesTo determine 1) the cost of hospitalization, the 1-week postdischarge cost, the total cost, and the economic burden of community-acquired pneumonia among patients aged 19 years or older in the Philippines and 2) the difference between the estimated costs and the Philippine Health Insurance Corporation (PhilHealth) pneumonia case rate payments. MethodsThe study involved two tertiary private hospitals in the Philippines. Using the societal perspective, both health care and non–health care costs were determined. A base-case analysis and sensitivity analyses were performed, and the economic burden of pneumonia was determined using PhilHealth claims. ResultsThe estimated cost of hospitalization for community-acquired pneumonia-moderate risk (CAP-MR) ranged from Philippine peso (PHP) 36,153 to 113,633 (US $852–2678) and its 1-week postdischarge cost ranged from PHP1450 to 8800 (US $34–207). The cost of hospitalization for community-acquired pneumonia-high risk (CAP-HR) ranged from PHP104,544 to 249,695 (US $2464–5885) and PHP101,248 to 243, 495 (US $2386–5739) using invasive and noninvasive ventilation, respectively. The postdischarge cost for CAP-HR ranged from PHP1716 to 10,529 (US $40–248). If only health care cost was considered, the cost ranged from PHP24,403 to 89,433 for CAP-MR and PHP92,848 to 213,395 for CAP-HR. The present PhilHealth case rate payments are PHP15,000 (US $354) and PHP32,000 (US $754) for CAP-MR and CAP-HR, respectively. Based on the number of PhilHealth claims for 2012 and the estimated health care cost, the economic burden of pneumonia in 2012 was PHP8.48 billion for CAP-MR and PHP643.76 million for CAP-HR. ConclusionsThe estimated health care cost of hospitalization is markedly higher than the PhilHealth case rate payments. As per the study results, the economic burden of pneumonia is, thus, significantly higher than PhilHealth estimates.

PIN45 - Economic Burden of Community-Acquired Pneumonia Among Adults In The Philippines Its Clinical and Policy Implications in the Case Rate Payments of The Philippine Health Insurance Corporation

To determine (1) the cost of hospitalization and 1-week post-discharge, (2) the difference between estimated costs and the Philippine Health Insurance Corporation (PhilHealth) pneumonia case rate payments, and (3) the economic burden of community-acquired pneumonia (moderate and high-risk, CAP-MR and CAP-HR, respectively) among patients aged > 19 years old in the Philippines. The study involved two tertiary private hospitals in the Philippines. Using the societal perspective, out-of-pocket expenses and productivity losses were computed. A base case and sensitivity analyses were performed and the economic burden of pneumonia was determined using Philhealth claims. The estimated cost of hospitalization for CAP-MR was PhP 36,153 - 113,633 (US$852 – 2,678) and the1-week post-discharge cost for CAP-MR was PhP 1,450 – 8,800 (US$ 34 – 207) The cost of hospitalization for CAP-HR was PhP 104,544 – 249,695 (US$2,464 – 5,885) and PhP 101,248 – 243, 495 (US$2,386 – 5,739) with the use of either invasive ventilation or non-invasive ventilation, respectively. The post discharge cost for CAP-HR was PhP 1,716 – 10,529 (US$40 – 248). In comparison, the present PhilHealth case rate payments for CAP-MR is PhP 15,000 (US$354) and PhP 32,000 (US$754) for CAP-HR. Based on the number of PhilHealth claims for the year 2012 and the study results, the economic burden of pneumonia in 2012 was PhP 8.48 billion for CAP-MR and PhP 643.76 million for CAP-HR. The paper reported the hospitalization and follow-up costs of CAP-MR and CAP-HR based on the societal perspective. It showed significant difference from the current case rate payments of the Philippine Health Insurance Corporation.

Economic burden of community-acquired pneumonia and invasive pneumococcal diseases in subjects aged ≥50 years: the Italian situation

Background Streptococcus pneumoniae (Spn) is a common cause of Community-Acquired Pneumonia (CAP) and Invasive Pneunmococcal Diseases (IPD) and an important cause of health care costs. The purpose of this cost-of-illness analysis (COI) is to estimate the economic burden of diseases caused by Spn among people ≥50 years old in Italy. Methods This analysis was performed from the Italian National Health Service perspective. Only direct medical costs related to outpatient and inpatient care were …

Clinical and Economic Burden of Community-Acquired Pneumonia among Adults in the Czech Republic, Hungary, Poland and Slovakia

We estimate and describe the incidence rates, mortality, and cost of CAP (community-acquired pneumonia), in both inpatient and outpatient settings, in the Czech Republic (CZ), Slovakia (SK), Poland (PL), and Hungary (HU). A retrospective analysis was conducted on administrative data from the health ministry and insurance reimbursement claims with a primary diagnosis of pneumonia in 2009 to determine hospitalization rates, costs, and mortality in adults ≥50 years of age. Patient chart reviews were conducted to estimate the number of outpatient cases. Among all adults ≥50 years, the incidence of hospitalized CAP per 100,000 person years was: 456.6 (CZ), 504.6 (SK), 363.9 (PL), and 845.3 (HU). The average fatality rate for all adults ≥50 is 19.1%, and for each country; 21.7% (CZ), 20.9% (SK), 18.6% (PL), 17.8% (HU). Incidence, fatality, and likelihood of hospitalization increased with advancing age. Total healthcare costs of CAP in EUR was 12,579,543 (CZ); 9,160,774 (SK); 22,409,085 (PL); and 18,298,449 (HU); with hospitalization representing over 90% of the direct costs of treatment. The burden of CAP increases with advancing age in four CEE countries, with hospitalizations driving the costs of CAP upwards in the elderly population. Mortality rates are generally higher than reported in Western EU countries.

Clinical and economic burden of community-acquired pneumonia amongst adults in the Asia-Pacific region

Community-acquired pneumonia (CAP) is an important cause of mortality and morbidity amongst adults in the Asia-Pacific region. Literature published between 1990 and May 2010 on the clinical and economic burden of CAP amongst adults in this region was reviewed. CAP is a significant health burden with significant economic impact in this region. Chronic obstructive pulmonary disease, cardiovascular disease, diabetes mellitus and advanced age were risk factors for CAP. Aetiological agents included Streptococcus pneumoniae, Klebsiella pneumoniae, Gram-negative bacteria, Mycobacterium tuberculosis, Burkholderia pseudomallei, Staphylococcus aureus and atypical pathogens ( Mycoplasma pneumoniae, Chlamydophila pneumoniae and Legionella spp.), with important differences in the prevalence of these pathogens within the region. Antibiotic resistance was significant but was not linked to excess mortality. Aetiological pathogens remained susceptible to newer antimicrobial agents. Rational antibiotic use is essential for preventing resistance, and increased surveillance is required to identify future trends in incidence and aetiology and to drive treatment and prevention strategies.

Cost-Effectiveness and Antimicrobial Resistance in Community-Acquired Pneumonia

Community-acquired pneumonia (CAP) covers those infections of the lung parenchyma that are not acquired in hospital or a long-term care facility. CAP is a common infectious disease, with annual incidence rates of 1.6 per 1,000 adults in Spain and 11.6 per 1,000 adults in Finland [1, 2]. CAP is associated with significant morbidity and is the leading cause of death due to infection in developed countries [3, 4]. The economic burden of CAP is substantial: in the United States, CAP accounts each year for 10 million physician visits, and about 1 million hospitalizations at an estimated hospital cost of $9 billion [5, 6].