To the Editors:
Pneumonia imposes a significant burden on a population, not only in terms of morbidity and mortality but also economically 1–3. Direct costs generally increase from community-acquired pneumonia (CAP; US$25,218), healthcare-associated pneumonia (HCAP; US$27,647), hospital-acquired pneumonia (HAP; US$65,292) to ventilator-associated pneumonia (US$150,841) and reflect the level of care and length of hospitalisation 1. The prevalence of elderly patients with pneumonia admitted to hospital is rising and it has been suggested that greater effort is required to vaccinate these individuals and identify other comorbid factors 4. Even amongst employed patients with CAP, the majority of direct costs (59%) are attributable to a small proportion of individuals (10%) who require hospitalisation 2. Colice et al …