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.

Older adults are in an increased risk of respiratory infections including community acquired pneumonia (CAP). The former socialistic countries of the central Europe form a unique region with specific health care and epidemiology characteristics, and where the local evidence on the underlying epidemiology is scarce. The objective was to estimate the economic burden of CAP in adults Ն50 years of age in the Czech Republic (CR), Slovakia (SK), Poland (PL), and Hungary (HU) using data from 2010. METHODS: The incidence of hospitalized CAP stratified by age groups 50-64, 65-74, 75-84 and Ն85 was obtained from national surveillance systems (PL, CR, SK) and insurance records (HU). The estimates of non-hospitalised CAP incidence was based on retrospective chart reviews (CZ, SK, PL) and the insurance fund records (HU). Direct costs from the payer's perspective were based on resource use analyses (CR, SK), DRG lists (PL) and the insurance records (HU). RESULTS: The incidence of hospitalized CAP per 100,000 person years was: 456.6 (CR), 504.6 (SK), 363.9 (PL), and 845.3 (HU). Compared with adults 50-64 years of age, the incidence of hospitalised CAP were 2.3 fold higher in those 65-74, 5.2 fold higher in 75-84 and 10.8 fold higher in those Ն85, manifesting an exponential trend. While the majority of CAP among adults 50-64 years of age was treated outpatient, the proportion of CAP hospitalized increased with increasing age. The total burden of CAP in adults over 50 was € 12,579,543 (CR); 9,160,774 (SK); 22,409,085 (PL); and 18,298,449 (HU); with hospitalization representing over 90% of the direct costs of treatment in all 4 countries. Adults Ն65, who represent 41% of the combined population, account for 73% of the costs. CONCLUSIONS: The incidence and likelihood of hospitalisation drives the costs of CAP upwards with increasing age in the new central EU countries.

estimate costs for in-and outpatients. RESULTS: Among the 264_PAND and 132_POST inpatients, 30% were Ͻ18 years old, and 45% were women. The mean length of stay at general ward was of 6.5(6.1)-7.0(6.6) days (PAND and POST, respectively); and between 8.2(5.0) and 11.5(15.2) days for ICU patients (7%_PAND and 20%_POST). Among employed (45.3% PAND and 37.7% POST) most went on sick leave (99% and 93%) for about 31(37) and 38( 27) days. Among outpatients (215_PAND and 175_POST), about 25-35% were under 17 years old, and 50-57% were women. The 94%(PAND) and 82%(POST) of employed (64,9% and 68,0%, respectively) went on sick leave. Absenteeism length of was 11(12)-7(45) days. The mean cost per inpatient was 6,028 € (SDϭ6,251) in PAND and 6,939€(SDϭ10,895) in POST. For outpatients the mean cost was 749€ (SDϭ886) in PAND and 421€ (SDϭ686) in POST. CONCLUSIONS: Contrary to what expected, resource utilization was quite similar for both influenza waves. However, differences on mean cost were found due to the slightly increase in inpatients health care utilization, and the decrease of absenteeism among outpatients during the post-pandemic wave. These results would be useful to assess the influenza real burden in Spain; both at individual and population level.