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. 2018 Sep 14;18(1):715.
doi: 10.1186/s12913-018-3529-4.

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

Sabine Tong  1 , Caroline Amand  2 , Alexia Kieffer  3 , Moe H Kyaw  4   5
Affiliations

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

Sabine Tong et al. BMC Health Serv Res. .

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.

Keywords: Epidemiology; Healthcare cost; Healthcare utilization; Pneumonia; United States.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

C.A. is an employee of Sanofi, and A.K. and M.H.K. are employees of Sanofi Pasteur. S.T. was paid by Sanofi Pasteur for statistical analyses included in this manuscript.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Overall rate of index pneumonia cases between 2008 and 2014
Fig. 2
Fig. 2
Seasonality of frequency of pneumonia cases per 1000 person-months in the US, 2008–2014
See this image and copyright information in PMC

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