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Clinical and Economic Burden of Community‐Acquired Pneumonia in the Medicare Fee‐for‐Service Population
Author(s) -
Yu Holly,
Rubin Jaime,
Dunning Stephan,
Li Suying,
Sato Reiko
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.04208.x
Subject(s) - medicine , incidence (geometry) , population , pneumonia , community acquired pneumonia , demography , outpatient visits , case fatality rate , inpatient care , retrospective cohort study , emergency medicine , pediatrics , gerontology , environmental health , health care , physics , sociology , economic growth , optics , economics
Objectives To estimate current community‐acquired pneumonia ( CAP ) incidence and its associated economic burden in the M edicare fee‐for‐service ( FFS ) population. Design Retrospective. Setting The 2007/08 M edicare S tandard A nalytic F iles, a nationally representative random sample (5%) of Medicare beneficiaries enrolled in the FFS program. Participants Residents of one of the 50 U . S . states or the D istrict of C olumbia aged 18 and older on J uly 1, 2007, with continuous P art A and P art B coverage during calendar year 2007. Measurements Incidence, episode length, mortality, and costs were assessed. All‐cause costs were assessed using three methodologies: costs during the episode, and incremental costs using CAP cases as self‐control (before–after) and with matched controls (case–control). Results Sixty‐five thousand eight hundred four CAP episodes (39% inpatient‐treated episodes) were identified. Average inpatient and outpatient episode lengths were 32.8 ± 46.9 and 12.4 ± 27.3 days, respectively, and overall incidence was 4,482/100,000 person‐years. Thirty‐day case fatality was 8.5% for inpatient and 3.8% for outpatient CAP . The average CAP episode cost was $8,606 ($18,670 for inpatient, $2,394 for outpatient). The incremental cost of a CAP episode in the before‐and‐after and case–control analyses was approximately $10,000. Conclusion An estimated 1.3 million CAP cases and 74,000 CAP ‐related deaths were found, with an economic burden of $13 billion annually in the Medicare fee‐for‐service population. Preventing CAP in this population may substantially reduce healthcare costs.

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