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. 2018 Aug 31;6(3):59.
doi: 10.3390/vaccines6030059.

Relative Clinical and Cost Burden of Community-Acquired Pneumonia Hospitalizations in Older Adults in the United States-A Cross-Sectional Analysis

Omotola Olasupo  1 , Hong Xiao  2 , Joshua D Brown  3
Affiliations

Relative Clinical and Cost Burden of Community-Acquired Pneumonia Hospitalizations in Older Adults in the United States-A Cross-Sectional Analysis

Omotola Olasupo et al. Vaccines (Basel). .

Abstract

The relative burden of community-acquired pneumonia (CAP) in older adults (≥65 years old) compared to other serious diseases is important to prioritize preventive treatment. A retrospective analysis was conducted using the 2014 National Readmission Database to evaluate the length of stay, inpatient mortality, 30-day readmissions, and costs of CAP compared to diabetes mellitus (DM), myocardial infarction (MI), and stroke. 275,790 hospitalizations were analyzed and represented a national estimate of 616,300 hospitalizations, including 269,961 for CAP, 71,284 for DM, 126,946 for MI, and 148,109 for stroke. The mean length of stay in CAP was 5.2 days, which was higher than DM (4.6) and MI (4.3) but similar to stroke (5.6). The inpatient mortality risk was lower for DM (RR: 0.37, 95% CI: 0.29⁻0.46) but higher for MI (RR: 1.67, 95% CI: 1.50⁻1.85) and stroke (RR: 1.67, 95% CI: 1.51⁻1.83). The median costs for CAP ($7282) were higher compared to DM ($6217) but lower compared to MI ($14,802) and stroke ($8772). The 30-day readmission rate was 17% in CAP, which was higher compared to MI (15%) and stroke (11.5%) and lower compared to DM (20.3%). In patients with CAP, disease burden is on par with other serious diseases. CAP should be prioritized for prevention in older adults with strategies such as vaccination and smoking cessation.

Keywords: burden of illness; community-acquired pneumonia; diabetes mellitus; elderly; myocardial infarction; stroke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Sample selection flow chart.
Figure 2
Figure 2
Comparison of hospitalization metrics for CAP, DM, MI, and stroke (a) Inpatient mortality; (b) 30-day readmissions rates; (c) length of hospital stay; (d) median cost per hospitalization; (e) total cost in millions of US dollars; (f) total cost in % contribution.
Figure 2
Figure 2
Comparison of hospitalization metrics for CAP, DM, MI, and stroke (a) Inpatient mortality; (b) 30-day readmissions rates; (c) length of hospital stay; (d) median cost per hospitalization; (e) total cost in millions of US dollars; (f) total cost in % contribution.
See this image and copyright information in PMC

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