The annual economic burden among patients hospitalized for community-acquired pneumonia (CAP): a retrospective US cohort study

Abstract

Objective: To assess the 1-year economic burden among patients hospitalized for community-acquired pneumonia (CAP) in the US.

Methods: Adult patients hospitalized for CAP between 1/2012 and 12/2016 were identified from the IQVIA hospital charge data master (CDM) linked to the IQVIA Real-World Data Adjudicated Claims – US Database (date of admission = index date). Patients had continuous enrollment 180-days pre- and 360-days post-index, and empiric antimicrobial treatment (monotherapy [EM] or combination therapy [EC]) and chest x-ray on the index date or day after. All-cause and CAP-related healthcare resource utilization and cost were assessed over the 1-year follow-up. Generalized linear models (GLM) examined adjusted total cost.

Results: The cohort comprised 1624 patients hospitalized for CAP (mean age 50.3; 52.8% female). The majority (78.2%) initiated EC, most frequently with beta-lactams + macrolides (30.4%). The index hospitalization was associated with a mean length of stay (LOS) of 5.7 days and mean cost of $17,736; 22.7% had a transfer to the intensive care unit (ICU). All-cause readmission rates at 30- and 180-days were 8.8% and 20.1%, respectively. Mean annual all-cause total cost was $61,928; one-third (33.8%, $20,954) was related to CAP. The primary cost driver was inpatient care, which accounted for more than half (56.0%) of total all-cause cost and 94.3% of total CAP-related cost. Mean total inpatient cost was significantly higher among EC versus EM patients ($37,106 versus $25,999, p = .0399). Adjusted mean total all-cause cost was $55,391.

Conclusions: Patients hospitalized for CAP incurred a significant annual economic burden, driven substantially by the high cost of hospitalizations.

Keywords:

• CAP
• community-acquired pneumonia
• pneumonia
• health care costs
• retrospective studies
• cost of illness
• administrative claims

Acknowledgements

The authors would like to thank Marya Zilberberg, MD, MPH, of EviMed Research Group, LLC, who provided clinical input in the study design.

Data availability statement

Original de-identified data used in this analysis were obtained from and are the property of IQVIA. IQVIA has restrictions prohibiting the authors from making the minimal data set publicly available. Interested researchers may contact IQVIA to apply to gain access to the study’s data in the same way the authors obtained the data (https://www.iqvia.com/contact/sf).