Direct Costs and Duration of Hospitalization of Patients Hospitalized with Community Acquired Pneumonia: a Nationwide Retrospective Claims Database Analysis
Methods: A retrospective study of claims data from a nationwide Dutch database (covering 16.7M inhabitants) was conducted. From this database (DBC information system), patients with at least one claim with a final diagnosis of CAP between January 2008 and December 2011 were selected. The main outcome measures were the direct hospitalization costs and the duration of hospitalization of CAP, both stratified by age and severity. Severity was defined based on the type of care received (“ICU” [i.e. inpatient CAP admitted for at least one night to the ICU], “general ward” [i.e. inpatient CAP only admitted at the general ward] or “outpatient” [i.e. ED and policlinic visits without an overnight stay and therefore not counted as hospitalization days]). For this study the population was divided into the following age-groups: 0-9; 10-17; 18-49; 50-64; 65-74; 75-84; ≥85 years.
Results: In total, 196,554 CAP cases were included in the analysis. Of these 123,673 (63%) were hospitalized for 1 or more nights of which 5.9% (n= 7,265) spend at least one night on the ICU. In total, these 123,673 patients spend 828,356 days in the hospital of which 51,745 (6.2%) were spend on the ICU. The total costs related to all CAP episodes during these 4 years was €714M, resulting in a mean cost of €3,631 euro per episode. Mean costs were highly dependent on age and type of care with costs ranging from €482 for 0-9 year olds treated outpatient up to €14,402 for 50-64 year olds admitted to the ICU. The mean duration of hospitalization of ICU patients and general ward patients was 15.2 days and 6.2 days, respectively. ICU patients spend 44% of their total admission time on the ICU (i.e. 6.7 days).
Conclusion: The financial burden of hospitalized CAP is high and varies significantly depending on age and the severity of the CAP. Effective interventions to prevent pneumonia could result in large cost savings.
Pfizer: Employee, Salary
M. Jonker, None
M. J. Mangen, None
M. Postma, Pfizer: Investigator and Scientific Advisor, Consulting fee, Educational grant, Research grant and Speaker honorarium