PIH14 Economic Burden of Community Acquired Pneumonia in Older Adults in the New EU Countries of the Central Europe

Abstract

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.