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

Rozenbaum, Mark H; Mangen, Marie-Josée J.; Huijts, Susanne M.; Werf, Tjip S. van der; Postma, Maarten J.

doi:10.1016/j.vaccine.2015.05.001

Cited by 99 publications

(79 citation statements)

References 25 publications

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“…Another nationwide ICD-based cost analysis by Rozenbaum et al [19] reported medium costs of CAP of €6060 and €5937 in those 65–74 and 75–84 years of age, respectively, which is also lower than the medium costs for these age cohorts in the current study (€8674 and €8770, respectively). The study by Rozenbaum et al was based on reimbursement of hospital expenses, as regulated by Diagnosis Related Groups (in Dutch: Diagnose BehandelCombinatie or DBC).…”

Section: Discussioncontrasting

confidence: 63%

“…In Western countries like the Netherlands, new healthcare interventions will be evaluated for their costs and effects and detailed cost estimates are indispensable in this process. However, most larger studies describing CAP costs were conducted retrospectively and based on insurance claims with limited clinical information [4, 14–19]. The few prospective studies on CAP hospitalization costs covered relative small cohorts only [20–22].…”

Section: Introductionmentioning

confidence: 99%

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Hospitalization costs for community-acquired pneumonia in Dutch elderly: an observational study

et al. 2016

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BackgroundCommunity-acquired pneumonia (CAP) is one of the most common infections, especially in the elderly (≥65 years). The aim of this study was to quantify hospitalization costs for CAP in different age groups and in patients with different CAP risk profiles. Secondary objectives were to assess disease severity differences between placebo and vaccine receiving participants and identify cost driving factors of CAP in hospitalized elderly in the Netherlands.MethodsThis prospective cohort study of hospitalized CAP patients was executed in parallel to the Community Acquired Pneumonia Immunization Trial in Adults (CAPiTA). Within the CAPiTA, a cohort of 84,496 subjects aged ≥65, all suspected CAP-episodes presenting in one of the 58 participating hospitals between September 2008 and August 2013 were included. CAP was diagnosed on clinical and radiographical criteria. Invasive pneumococcal disease (IPD) and non-IPD-CAP episodes, regardless of the causing pathogen, were evaluated separately. Costs were calculated by multiplying recorded healthcare resources with Dutch unit cost prices for the year 2012. Multivariate regression analysis was performed to identify cost drivers.ResultsIn the sentinel hospitals 3225 suspected CAP and IPD episodes were included, of which 1933 were radiographically confirmed by chest X-ray. Analyses were conducted on confirmed CAP episodes only. Overall mean length of hospital stay was 12.1 days, the in-hospital mortality rate was 11.26 %, and mean costs were €8301 (95 % CI: €7760–€8999). When stratified in age-categories 65–74, 75–84 and ≥85, mean hospitalization costs were €8674, €8770 and €6197, respectively (p = 0.649). IPD-CAP and non-IPD-CAP mean hospitalization costs were €13,611 and €8081, respectively. Higher CURB-65 score and individuals at medium risk for developing pneumococcal disease were significantly associated with higher costs. Being male, lower age, previous admissions, lower risk, lower urbanity and higher socio-economic status were associated with lower costs.ConclusionsMean hospitalization costs of a CAP subject were €8301 and higher for IPD-CAP compared to non-IPD-CAP cases. Medium risk patients and higher CURB-65 scores were identified as cost driving factors.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1783-9) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 63%

Section: Introductionmentioning

confidence: 99%

Hospitalization costs for community-acquired pneumonia in Dutch elderly: an observational study

et al. 2016

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“…The incidence is clearly higher in older adults. Recent published estimates from others countries include 130.5 per 10 000 adults aged over 65 years in Malaysia, 25 172.4 cases per 10 000 for adults aged 85 and over in the Netherlands, 26 and 29.6 per 10 000 for all ages and 76.5 for adults aged 65 and over in Germany. 27 …”

Section: Introductionmentioning

confidence: 99%

Advances in the causes and management of community acquired pneumonia in adults

Wunderink

Waterer

2017

BMJ

158

112

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Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia. Optimal treatment remains a matter for debate, especially in very sick patients, including the role of combination antibiotic therapy and corticosteroids. Pneumonia care bundles are being defined to improve outcomes. Increased recognition of both acute and long term cardiac complications is shifting our concept of pneumonia from an acute lung disease to a multisystem problem with adverse chronic health consequences.

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“…In the United States, it is estimated that there are around 5.2 million adult patients with CAP, and the majority of these individuals are above 65 years old (4.200 out of every 100.000 people) [8]. In the Netherlands, 45% of patients with CAP are above 65 years old [9]. Risk factors for CAP include old age and comorbidity.…”

Section: Resultsmentioning

confidence: 99%

Cost-Effectiveness Analysis of Ceftriaxone-Azithromycin Combination and Single Levofloxacin as Empirical Antibiotics in Community-Acquired Pneumonia Inpatients at Persahabatan Hospital

Suratini

Sauriasari

Hamadah³

2017

Asian J Pharm Clin Res

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Objective: Community-acquired pneumonia (CAP) is one of the most common infectious diseases. Its prevalence is especially concerning, as the disease severely impacts health and has a high mortality rate. Although antibiotics have been used to treat CAP, their use is often costly and inefficient. Thus, this study aimed to determine the cost-effectiveness of using ceftriaxone-azithromycin combination and single levofloxacin as empirical antibiotics to treat patients with CAP. Cost-effectiveness was analyzed by comparing the direct total medical cost to clinical effectiveness, which was indicated by the respective success rates in each treatment group.Methods: This study was conducted at Persahabatan Hospital in Jakarta and employed an observational study design, where data were obtained retrospectively from the secondary data contained in medical records for 2014-2016. A total of 100 patients were included in the analysis, with 64 patients using intravenous (iv) antibiotic ceftriaxone and oral azithromycin and 36 patients using iv single levofloxacin. Results:The median costs of antibiotics were significantly different between the ceftriaxone-azithromycin group and the levofloxacin group: Rp.130.756 and Rp.286.952, respectively. The direct total medical cost in the ceftriaxone-azithromycin group (Rp.6.494.998) was higher than that of the single levofloxacin group (Rp.5.444.242). The success rate was 95.3% in the ceftriaxone-azithromycin group and 97.2% in the levofloxacin group, but there were no significant differences between the two groups. The medians for the length of stay (LOS) and length of stay antibiotic-related (LOSAR) measures in the levofloxacin group were 6 and 5 days, which were shorter than the LOS and LOSAR medians in the ceftriaxone-azithromycin group: 7 days and 6 days, respectively. The average cost-effectiveness ratio value in the levofloxacin group was 56.011% effectiveness lower than that of the ceftriaxone-azithromycin group, which was Rp.68.153% effectiveness. Conclusions:Based on these results, it can be concluded that levofloxacin is more cost-effective than a combination of ceftriaxone-azithromycin for treating CAP.

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

Abstract: There is a large variation in terms of incidence, disease burden and costs across different age groups and the treatment setting. Effective interventions, targeted at older adults, to prevent pneumonia could reduce the (financial) burden due to pneumonia.

Cited by 99 publications

References 25 publications

Hospitalization costs for community-acquired pneumonia in Dutch elderly: an observational study

Hospitalization costs for community-acquired pneumonia in Dutch elderly: an observational study

Advances in the causes and management of community acquired pneumonia in adults

Cost-Effectiveness Analysis of Ceftriaxone-Azithromycin Combination and Single Levofloxacin as Empirical Antibiotics in Community-Acquired Pneumonia Inpatients at Persahabatan Hospital

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