Retrospective epidemiological study for the characterization of community- acquired pneumonia and pneumococcal pneumonia in adults in a well-defined area of Badalona (Barcelona, Spain)

BMC Infectious Diseases

Lorenzo Aguilar⁶  Ruth Navarro-Artieda²  Pablo Guijarro⁵  Isabel Cifuentes³  Jordi Ibáñez-Nolla¹  Antoni Sicras-Mainar⁴ 

[1] Hospital Municipal de Badalona, Badalona, Barcelona, Spain;Medical Documentation Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain;Medical Department, Pfizer S.L.U., Alcobendas, Madrid, Spain;Planning Management Department, Dirección de Planificación y Desarrollo Organizativo, Badalona Serveis Assistencials SA, Gaietà Soler, 6-8 entlo, 08911, Badalona, Barcelona, Spain;Pharmacoeconomics Department, Pfizer S.L.U., Alcobendas, Madrid, Spain;Microbiology Department, School of Medicine, Universidad Complutense, Madrid, Spain

关键词: Health costs;    Resource utilization;    Hospital setting;    Primary care setting;    Streptococcus pneumoniae;    Community-acquired pneumonia;   

Others  :  1159608
DOI  :  10.1186/1471-2334-12-283

 received in 2012-03-08, accepted in 2012-10-25,  发布年份 2012

【 摘 要 】

Background

Community-acquired pneumonia (CAP) has large impact on direct healthcare costs, especially those derived from hospitalization. This study determines impact, clinical characteristics, outcome and economic consequences of CAP in the adult (≥18 years) population attended in 6 primary-care centers and 2 hospitals in Badalona (Spain) over a two-year period.

Methods

Medical records were identified by codes from the International Classification of Diseases in databases (January 1^st 2008-December 31^st 2009).

Results

A total of 581 patients with CAP (55.6% males, mean age 57.5 years) were identified. Prevalence: 0.64% (95% CI: 0.5%-0.7%); annual incidence: 3.0 cases/1,000 inhabitants (95% CI: 0.2-0.5). Up to 241 (41.5%) required hospitalization. Hospital admission was associated (p<0.002) with liver disease (OR=5.9), stroke (OR=3.6), dementia (OR=3.5), COPD (OR=2.9), diabetes mellitus (OR=1.9) and age (OR=1.1 per year). Length of stay (4.4±0.3 days) was associated with PSI score (β=0.195), in turn associated with age (r=0.827) and Charlson index (r=0.497). Microbiological tests were performed in all inpatients but only in 35% outpatients. Among patients with microbiological tests, results were positive in 51.7%, and among them, S pneumoniae was identified in 57.5% cases. Time to recovery was 29.9±17.2 days. Up to 7.5% inpatients presented complications, 0.8% required ICU admission and 19.1% readmission. Inhospital mortality rate was 2.5%. Adjusted mean total cost was €2,332.4/inpatient and €698.6/outpatient (p<0.001). Patients with pneumococcal CAP (n=107) showed higher comorbidity and hospitalization (76.6%), higher PSI score, larger time to recovery and higher overall costs among inpatients.

Conclusions

Strategies preventing CAP, thus reducing hospital admissions could likely produce substantial costs savings in addition to the reduction of CAP burden.

【 授权许可】

   
2012 Sicras-Mainar et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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