1244. Streptococcus pneumoniae Community-Acquired Pneumonia (SP-CAP) in a French Cohort of Hospitalized Patients : Economic Burden and Impact on Quality of Life (QoL).
Session: Poster Abstract Session: Clinical Infectious Diseases: Respiratory Infections
Friday, October 28, 2016
Room: Poster Hall

Background: Documenting the economic burden of SP-CAP and its impact on QoL is essential to define efficient vaccination strategies. The PNEUMOCOST study evaluated prospectively theses parameters.

Methods:

Hospitalized adults pts with confirmed SP-CAP were prospectively enrolled from Oct 2011 to April 2014 from forty centers. Cost of hospitalization and pts treatments were estimated over a six month period after discharge. QoL was evaluated by using the EQ-5D (3L) questionnaire at 1, 3 and 6 months after discharge. Health states were valued with the French Tariff.

Results:

524 pts were included: 55% were men, average age was 63 yrs old and 77% of pts were ≥ 50 yrs old. Average length of stay was 15 days. Distribution of the Charlson score at admission was : 39% <3, 35% between 3 and 5, and 24% six and over. Distribution of Port score was as follows: 23% of pts were in Class I and II, 21% in Class III and 55% in Class IV and V.

Average cost of stay to the French Sickness Fund was € 7,293 (std: € 7,363). Average cost of treatment after discharge (n=297) was € 834.94 (std: € 1 706.86). Workloss compensation contributed to a substantial share of total costs. 7.05% of patients were rehospitalized with an overall cost of €59,959.

QoL average scores were respectively 0.49, 0.66 and 0.72 at 1, 3 and 6 month respectively (Graph 1). At month 6, patients reached a score similar to the score observed in the French population for the same age and gender group. The Port score is the best predictor of QoL score at month 1, then the Charlson score at month 3 and 6. Restricted to patients with QoL scores for the three periods (n= 280) the episode had the main impact on mobility and usual activities. QoL improved on all dimensions through time (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). Scores at Month 3 and 6 were not significantly different.

Conclusion:

The initial hospitalization is the main driver of costs for SP-CAP and strongly related to severity. For the sickness fund, compensating for workloss is the main cost item. Hospitalized SP-CAP have a strong and durable impact on HRQoL. Pts are impacted mainly on their mobility and usual activities and recover progressively after 3 months.

Christian Chidiac, MD, PhD1, Pierre Bonnin, MD2, Bruno Detournay, MD, MBA3, Hajnal-Gabriela Illes, MD4, Jacques Gaillat, MD2, Henri Laurichesse, MD5, Jonathan Messika, MD6, Jean-Damien Ricard, MD6, Grèce Saba, PharmD, Msc7, Patrick Petitpretz, MD8 and Gerard De Pouvourville, MD9, (1)ID Department, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France, (2)CH Annecy_Gennevois, Annecy, France, (3)CEMKA-EVAL, Bourg-la-Reine, France, (4)CH Emile Roux, Le Puy en Velay, France, (5)MD, Clermont-Ferrand, France, (6)Hôpital Louis Mourier, APHP, Colombes, Colombes, France, (7)Chair of Health Systems, ESSEC Business School, Cergy-Pontoise, France, (8)CH Versailles, Versailles, France, (9)ESSEC, Cergy, France

Disclosures:

C. Chidiac, PFIZER: Investigator and Scientific Advisor , Educational support

P. Bonnin, None

B. Detournay, None

H. G. Illes, None

J. Gaillat, PFIZER: JAQCUES GAILLAT and Scientific Advisor , Speaker honorarium

H. Laurichesse, PFIZER: Scientific Advisor , Consulting fee

J. Messika, BASILEA: Consultant , Consulting fee

J. D. Ricard, None

G. Saba, None

P. Petitpretz, PFIZER: Scientific Advisor , Consulting fee

G. De Pouvourville, PFIZER: Scientific Advisor , Research grant

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