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A population-based study of the costs of care for community-acquired pneumonia

¹ Consorci Sanitari de Mataró, Mataró, ² Dept of Pneumology, Hospital Universitari Germans Trias i Pujol, Badalona, and ³ Dept of Epidemiology, Catalonian Institute of Oncology, Hospital Duran i Reinals, L'Hospitalet de Llobregat, ⁴ Faculty of Economics, Pompeu Fabra University, and ⁵ Servei d'Epidemiologia Clinica i Salut Pública, Hospital Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

CORRESPONDENCE: J. Almirall, Intensive Care Unit, Hospital de Mataró, Carretera de Cirera s/n, E-08304, Mataró, Barcelona, Spain. Fax: 34 937417770. E-mail: jalmirall@csm.scs.es

Keywords: Community-acquired pneumonia, cost reduction, direct costs, length of stay, site of care

Received: July 4, 2003
Accepted November 25, 2003

This study was supported by a grant (97/0718) from the Health Investigation Fund, Madrid, Spain.

In a population-based study, the consumption of resources for treating adult patients with community-acquired pneumonia was determined.

During a 2-yr period, all cases with a clinical and radiological suspicion of community-acquired pneumonia that occurred in patients aged >14 yrs in a community of 74,610 inhabitants were investigated prospectively.

Of 292 cases with a suspicion of community-acquired pneumonia, 224 were included (18.5% misdiagnoses). The mean number of visits per patient was 4.5 (72% in the primary care setting). Inpatient care was recommended in 59.8% of cases; after discharge, 44% of patients were managed in outpatient clinics. The mean direct cost of pneumonia treated in the hospital setting was (euros)1,553, whereas the mean cost of cases treated as outpatients was 196. A total of 15.7% of admissions were considered inappropriate and the length of stay could have been reduced by 3.5 days in the most severe cases. A reduction in inappropriate admissions and lengths of hospital stay would result in a decrease in cost of 17.4%.

Community-acquired pneumonia in Maresme, Spain, occurs at a low incidence, although with a high percentage of hospitalisations (in part inappropriate), resulting in considerable costs.

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