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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Health Services Research 1/2018

Trends in healthcare utilization and costs associated with pneumonia in the United States during 2008–2014

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2018
Autoren:
Sabine Tong, Caroline Amand, Alexia Kieffer, Moe H. Kyaw
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12913-018-3529-4) contains supplementary material, which is available to authorized users.

Abstract

Background

Pneumonia is the leading cause of morbidity and mortality worldwide. Pneumococcal conjugate vaccines have reduced the burden of pneumonia, but data on the current burden of pneumonia and its impact on the healthcare system are needed to inform the development and use of new vaccines and other preventive measures.

Methods

We retrospectively analyzed the frequency of pneumonia in the US during 2008–2014 using data from the MarketScan® Commercial Claims and Encounters database. Frequencies of healthcare utilization related to the index pneumonia episode were calculated using the annual number of enrolled person-years (PY) as the denominator and the number of individuals with pneumonia as the numerator. Pneumonia-associated costs were calculated as mean payment per episode during the 2 years from 2013 to 2014.

Results

The overall annual healthcare utilization rate for pneumonia was 15.1 per 1000 PY and decreased slightly from 2008 to 2014 (from 15.4 to 13.5 per 1000 PY). Most pneumonia-related healthcare utilization was due to office/outpatient visits (10.3 per 1000 PY; 68.3%). Emergency department/urgent care visits (2.5 per 1000 PY; 16.9%) and hospitalizations (2.2 per 1000 PY; 14.8%) contributed less. Pneumonia-related healthcare utilization was highest in children < 5 years (rate per 1000 PY = 29.7 for < 1 year, 47.9 for 1 year, and 39.5 for 2–4 years) and adults > 65 years (45.0 per 1000 PY). The mean cost per pneumonia episode (95% confidence interval) was US$429.1 ($424.8–$433.4) for office/outpatient visits, $1126.9 ($1119.5–$1134.3) for emergency department/urgent care visits, and $10,962.5 ($10,822.8–$11,102.2) for hospitalization.

Conclusions

The burden of pneumonia on the US healthcare system remains substantial. The results presented here can help guide new vaccination strategies and other preventive interventions for reducing the remaining burden of pneumonia.
Zusatzmaterial
Additional file 1: Table S1. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes used. (DOCX 13 kb)
12913_2018_3529_MOESM1_ESM.docx
Additional file 2: Table S2. Demographic characteristics of pneumonia patients by year. (DOCX 15 kb)
12913_2018_3529_MOESM2_ESM.docx
Additional file 3: Table S3. Frequency of index pneumonia visits per 1000 person-years by age group and year (DOCX 13 kb)
12913_2018_3529_MOESM3_ESM.docx
Additional file 4: Table S4. Proportion of pneumonia cases by setting, age group, and year (DOCX 15 kb)
12913_2018_3529_MOESM4_ESM.docx
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