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

Abstract

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.

Incidence, direct costs and duration of hospitalization of patients hospitalized with community acquired pneumonia: A nationwide retrospective claims database analysis

“…If we look at the same age-group in our study we observe an incidence of 535 per 100,000 population which is well in between the estimates of these other European countries. Similar to our study, all studies who reported age-specific incidences showed a steep increase in the incidence of hospitalized CAP with age in adults [4,7,8,19,20]. Although our observed incidences are similar to those described earlier one should take into account factors which can impact the country specific incidence of pneumonia, like immunization programs.…”

“…The incidence was estimated higher in a recent Portuguese study for the same age group, with 361 per 100,000 population [6]. Other recent studies found annual incidences of hospitalized CAPs of 366, 472, 518, 627 and 832 per 100,000 inhabitants for those aged ≥50 years in Czech republic, Slovakia, Poland, Spain and Hungary, respectively [5,8]. If we look at the same age-group in our study we observe an incidence of 535 per 100,000 population which is well in between the estimates of these other European countries.…”

“…Unfortunately, mortality data were not collected within the used database. Previous studies have shown huge variety in case-fatality rates of 0 up to 47%, but all showed an increasing mortality with age [4,7,8]. The high mortality rates in the oldest age groups can explain the lower duration of hospitalization of those admitted in the ICU aged ≥75 years and older compared to those age between 50 and 75 years.…”

Clinical burden of multi-cause and pneumococcal pneumonia, meningitis, and septicemia in Hungary. Results of a retrospective study (2006–2011)

“…A hospitalizációval járó közösségben szerzett pneumonia (CAP) 4 közép-és kelet-európai országban (CEE) végzett vizsgálatában 14,1/1000 fő magyarországi becsült hospitalizációs arányt számoltak ki a 65 évesnél idősebb felnőttek körében az OEP adatai alapján, ami lényegesen magasabb, mint az 1000 főre vetített 7,1-es, 8,3-es, illetve 9,4-es arány ugyanebben a korcsoportban Lengyelországban, a Cseh Köztársaságban, illetve Szlovákiában [27]. Azonban meg kell jegyezni, hogy a vizsgálatokban alkalmazott módszerek különbö-zősége és az eltérő évek, ahonnan az adatokat nyerték (2005-től 2010-ig) [27,28], valamint a tüdőgyulladás eltérő kórházi kezelési gyakorlata ezekben az országok-ban, nehezítik az országok közötti összehasonlítást. az idősebb felnőttek körében.…”

“…Ez összhangban van egyéb CEE-országokban [27], Németországban, Angliában és vizsgálatban [27]. Az időseknél megfi gyelt magas halá-lozási arány miatt a betegség megelőzése védőoltással rendkívül fontos.…”