Increasing hospital admissions for pneumonia, England

Abstract

Pneumonia is an important cause of illness and death in England. To describe trends in pneumonia hospitalizations, we extracted information on all episodes of pneumonia that occurred from April 1997 through March 2005 recorded in the Hospital Episode Statistics (HES) database by searching for International Classification of Diseases 10th revision codes J12-J18 in any diagnostic field. The age-standardized incidence of hospitalization with a primary diagnosis of pneumonia increased by 34% from 1.48 to 1.98 per 1,000 population between 1997-98 and 2004-05. The increase was more marked in older adults, in whom the mortality rate was also highest. The proportion of patients with recorded coexisting conditions (defined by using the Charlson Comorbidity Index score) increased over the study period. The rise in pneumonia hospital admissions was not fully explained by demographic change or increasing coexisting conditions. It may be attributable to other population factors, changes in HES coding, changes to health service organization, other biologic phenomenon, or a combination of these effects.

Figure 1

Trends in age-standardized incidence of hospital admission with a primary diagnosis of pneumonia-specific International Classification of Diseases (10th revision) codes, by Hospital Episode Statistics year (April to March). *Additional data on percentage of all admissions due to pneumonia published by the Information Centre for Health and Social Care (www.ic.nhs.uk). Data not available for 1997–98.

Figure 2

Percentage of patients admitted to hospital with a primary diagnosis of pneumonia with coexisting conditions, as defined by using the Charlson Comorbidity Index, by age group.

Figure 3

Percentage of patients admitted with a primary diagnosis of pneumonia who died in hospital with pneumonia within 30 days of their first pneumonia admission, by Hospital Episode Statistics year (April to March).