Community-acquired pneumonia: the annual cost to the National Health Service in the UK

Abstract

The aim of this study was to estimate the direct annual healthcare costs to the UK National Health Service (NHS) of managing community-acquired pneumonia.Using a prevalence-based burden of illness approach, health service resource use and corresponding costs attributable to the management of community-acquired pneumonia during 1992/1993 in the UK were obtained from published sources and commercial databases, and supplemented by a telephone survey of general practitioners, finance directors, community nurses, receptionists and nurses in out-patient respiratory clinics, ambulance services, and consultant respiratory physicians. The study was appraised by a Peer Review Panel, representing a cross-section of experts from different locations. This study was a predefined subgroup analysis of a previous, larger study that estimated the annual cost to the NHS of treating all community-acquired lower respiratory tract infections.The analysis shows that there are 261,000 episodes of community-acquired pneumonia annually in the UK, costing £440.7 million at 1992/1993 prices (32% of the annual cost for all community-acquired lower respiratory tract infections). Approximately 83,153 annual cases of community-acquired pneumonia are treated in hospital (32% of all episodes) and account for 96% of the annual cost. The average cost for managing pneumonia in the community is £100 per episode, compared to £1,700-£5,100 when the patient is hospitalized, depending on the length of hospitalization. Hospitalization accounts for 87% of the total annual cost.In conclusion, community-acquired pneumonia in the UK incurs a direct healthcare cost of £440.7 million annually at 1992/1993 prices. Developing and implementing strategies to prevent and minimize hospitalization will significantly reduce this annual cost and should be assessed in future studies.

Risk factors of treatment failure in community acquired pneumonia: implications for disease outcome

“…Treatment failure was also associated with more complications and a longer stay in hospital 28 which contributes to an increase in expenses as the cost per day of hospitalisation represents the highest health care cost for CAP. [29][30][31] This study has identified, at the time of hospital admission, patients who are especially prone to early and late treatment failure with an 11-fold higher mortality. Patients with liver disease, leucopenia, multilobar CAP, initial severity, and cavitation or pleural effusion on chest radiography have a higher risk of treatment failure.…”

Study on the utilities of the role of biomarkers like albumin, CRP, PCT and blood urea nitrogen to serum albumin (B/A) ratio in the prediction of development of complications, prognosis, and need of ICU during the course of CAP

“…This accentuates the importance of prompt, accurate diagnosis and severity of illness which approaches to decisions regarding the extremity of management. [19,20] 200 patients with CAP were enrolled in this study. The current study asserts that B/A ratio with 97.1 % sensitivity and 100 % specificity with AUC of 0.999 is a better marker for the deciding severity, need of ICU and development of any complications during the course of CAP.…”

Epidemiología de la neumonía del adulto adquirida en la comunidad

“…Los costos del cuidado de esta enfermedad han sido crecientes, concentrándose en los pacientes hospitalizados y admitidos a unidades de cuidado crítico por NAC grave 4,15 . Considerando que estamos en presencia de una patología infecciosa prevenible, cuya historia natural es conocida y que determina un quiebre en la caliEpidemiología de la neumonía del adulto adquirida en la comunidad -G. Valdivia C. …”

“…En cuanto a los cuidados mé-dicos otorgados a la población, la NAC ofrece la oportunidad de evaluar críticamente la gestión clínica, concordancia en el uso de arsenales terapéuticos atingentes con la realidad epidemiológica y la adecuada categorización de la gravedad del cuadro de neumonía utilizando los criterios disponibles para ello 4,8,9 . El manejo de esta enfermedad infecciosa conlleva el gasto de importantes recursos económicos susceptibles de ser reducidos, considerando que se trata de una patología prevenible 15 . Esto implica la generación, difusión y adherencia a protocolos y guías clínicas consensuadas y la provisión de atención en cantidad y oportunidad adecuadas.…”