TY - JOUR
T1 - Clinical and economic burden of community-acquired pneumonia in the Veterans Health Administration, 2011
T2 - a retrospective cohort study
AU - McLaughlin, John M.
AU - Johnson, Maribeth H.
AU - Kagan, Stephen A.
AU - Baer, Stephanie L.
N1 - Funding Information:
Funding support for this project was provided by Pfizer Inc. This material is the result of work supported with resources and the use of facilities at the Charlie Norwood VA Medical Center. The contents do not represent the views of the Department of Veterans Affairs or the United States Government.
Publisher Copyright:
© 2015, The Author(s).
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Purpose: The burden of community-acquired pneumonia (CAP) is not well described in the US Veterans Health Administration (VHA). Methods: CAP was defined as having a pneumonia diagnosis with evidence of chest X-ray, and no evidence of prior (90 days) hospitalization/long-term care. We calculated incidence rates of adult CAP occurring in inpatient or outpatient VHA settings in 2011. We also estimated the proportion of VHA CAP patients who were hospitalized, were readmitted within 30 days of hospital discharge, and died (any cause) in the year following diagnosis. Incremental costs during the 90 days following a CAP diagnosis were estimated from the perspective of the VHA. Results: In 2011, 34,101 Veterans developed CAP (35,380 episodes) over 7,739,757 VHA person-years. Median age of CAP patients was 65 years (95 % male). CAP incidence rates were higher for those aged ≥50 years. A majority of Veterans aged 50–64 (53 %) and ≥65 (66 %) years had ≥1 chronic medical (moderate risk) or immunocompromising (high risk) condition. Compared to those at low-risk (healthy), moderate- and high-risk Veterans were >3 and >6 times more likely to develop CAP, respectively. The percentage of CAP patients who were hospitalized was 45 %, ranging from 12 % (age 18–49, low risk) to 57 % (age ≥65, high risk). One-year all-cause mortality rates ranged from 1 % (age 18–49, low risk) to 36 % (age ≥65, high risk). Annual VHA medical expenditure related to CAP was estimated to be $750 million (M) ($415M for those aged ≥65 years). Conclusion: A focus on CAP prevention among older Veterans and those with comorbid or immunocompromising conditions is important.
AB - Purpose: The burden of community-acquired pneumonia (CAP) is not well described in the US Veterans Health Administration (VHA). Methods: CAP was defined as having a pneumonia diagnosis with evidence of chest X-ray, and no evidence of prior (90 days) hospitalization/long-term care. We calculated incidence rates of adult CAP occurring in inpatient or outpatient VHA settings in 2011. We also estimated the proportion of VHA CAP patients who were hospitalized, were readmitted within 30 days of hospital discharge, and died (any cause) in the year following diagnosis. Incremental costs during the 90 days following a CAP diagnosis were estimated from the perspective of the VHA. Results: In 2011, 34,101 Veterans developed CAP (35,380 episodes) over 7,739,757 VHA person-years. Median age of CAP patients was 65 years (95 % male). CAP incidence rates were higher for those aged ≥50 years. A majority of Veterans aged 50–64 (53 %) and ≥65 (66 %) years had ≥1 chronic medical (moderate risk) or immunocompromising (high risk) condition. Compared to those at low-risk (healthy), moderate- and high-risk Veterans were >3 and >6 times more likely to develop CAP, respectively. The percentage of CAP patients who were hospitalized was 45 %, ranging from 12 % (age 18–49, low risk) to 57 % (age ≥65, high risk). One-year all-cause mortality rates ranged from 1 % (age 18–49, low risk) to 36 % (age ≥65, high risk). Annual VHA medical expenditure related to CAP was estimated to be $750 million (M) ($415M for those aged ≥65 years). Conclusion: A focus on CAP prevention among older Veterans and those with comorbid or immunocompromising conditions is important.
KW - Burden of disease
KW - Community-acquired pneumonia
KW - Epidemiology
KW - Risk factor
KW - Risk status
KW - Veterans
UR - http://www.scopus.com/inward/record.url?scp=84948102250&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84948102250&partnerID=8YFLogxK
U2 - 10.1007/s15010-015-0789-3
DO - 10.1007/s15010-015-0789-3
M3 - Article
C2 - 25980561
AN - SCOPUS:84948102250
SN - 0300-8126
VL - 43
SP - 671
EP - 680
JO - Infection
JF - Infection
IS - 6
ER -