Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity,

Objective: To assess the direct and indirect costs of diagnosing and treating community-acquired pneumonia (CAP), correlating those costs with CAP severity at diagnosis and identifying the major cost drivers. Methods: This was a prospective cost analysis study using bottom-up costing. Clinical sever...

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Main Authors: Vojislav Cupurdija, Zorica Lazic, Marina Petrovic, Slavica Mojsilovic, Ivan Cekerevac, Nemanja Rancic, Mihajlo Jakovljevic
Format: Article
Language:English
Published: Sociedade Brasileira de Pneumologia e Tisiologia 2015-02-01
Series:Jornal Brasileiro de Pneumologia
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132015000100048&lng=en&tlng=en
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author Vojislav Cupurdija
Zorica Lazic
Marina Petrovic
Slavica Mojsilovic
Ivan Cekerevac
Nemanja Rancic
Mihajlo Jakovljevic
author_facet Vojislav Cupurdija
Zorica Lazic
Marina Petrovic
Slavica Mojsilovic
Ivan Cekerevac
Nemanja Rancic
Mihajlo Jakovljevic
author_sort Vojislav Cupurdija
collection DOAJ
description Objective: To assess the direct and indirect costs of diagnosing and treating community-acquired pneumonia (CAP), correlating those costs with CAP severity at diagnosis and identifying the major cost drivers. Methods: This was a prospective cost analysis study using bottom-up costing. Clinical severity and mortality risk were assessed with the pneumonia severity index (PSI) and the mental Confusion-Urea-Respiratory rate-Blood pressure-age ≥ 65 years (CURB-65) scale, respectively. The sample comprised 95 inpatients hospitalized for newly diagnosed CAP. The analysis was run from a societal perspective with a time horizon of one year. Results: Expressed as mean ± standard deviation, in Euros, the direct and indirect medical costs per CAP patient were 696 ± 531 and 410 ± 283, respectively, the total per-patient cost therefore being 1,106 ± 657. The combined budget impact of our patient cohort, in Euros, was 105,087 (66,109 and 38,979 in direct and indirect costs, respectively). The major cost drivers, in descending order, were the opportunity cost (lost productivity); diagnosis and treatment of comorbidities; and administration of medications, oxygen, and blood derivatives. The CURB-65 and PSI scores both correlated with the indirect costs of CAP treatment. The PSI score correlated positively with the overall frequency of use of health care services. Neither score showed any clear relationship with the direct costs of CAP treatment. Conclusions: Clinical severity at admission appears to be unrelated to the costs of CAP treatment. This is mostly attributable to unwarranted hospital admission (or unnecessarily long hospital stays) in cases of mild pneumonia, as well as to over-prescription of antibiotics. Authorities should strive to improve adherence to guidelines and promote cost-effective prescribing practices among physicians in southeastern Europe.
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spelling doaj.art-05469173040443bdbec28d532d4b28a22022-12-22T03:18:29ZengSociedade Brasileira de Pneumologia e TisiologiaJornal Brasileiro de Pneumologia1806-37562015-02-01411485710.1590/S1806-37132015000100007S1806-37132015000100048Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity,Vojislav CupurdijaZorica LazicMarina PetrovicSlavica MojsilovicIvan CekerevacNemanja RancicMihajlo JakovljevicObjective: To assess the direct and indirect costs of diagnosing and treating community-acquired pneumonia (CAP), correlating those costs with CAP severity at diagnosis and identifying the major cost drivers. Methods: This was a prospective cost analysis study using bottom-up costing. Clinical severity and mortality risk were assessed with the pneumonia severity index (PSI) and the mental Confusion-Urea-Respiratory rate-Blood pressure-age ≥ 65 years (CURB-65) scale, respectively. The sample comprised 95 inpatients hospitalized for newly diagnosed CAP. The analysis was run from a societal perspective with a time horizon of one year. Results: Expressed as mean ± standard deviation, in Euros, the direct and indirect medical costs per CAP patient were 696 ± 531 and 410 ± 283, respectively, the total per-patient cost therefore being 1,106 ± 657. The combined budget impact of our patient cohort, in Euros, was 105,087 (66,109 and 38,979 in direct and indirect costs, respectively). The major cost drivers, in descending order, were the opportunity cost (lost productivity); diagnosis and treatment of comorbidities; and administration of medications, oxygen, and blood derivatives. The CURB-65 and PSI scores both correlated with the indirect costs of CAP treatment. The PSI score correlated positively with the overall frequency of use of health care services. Neither score showed any clear relationship with the direct costs of CAP treatment. Conclusions: Clinical severity at admission appears to be unrelated to the costs of CAP treatment. This is mostly attributable to unwarranted hospital admission (or unnecessarily long hospital stays) in cases of mild pneumonia, as well as to over-prescription of antibiotics. Authorities should strive to improve adherence to guidelines and promote cost-effective prescribing practices among physicians in southeastern Europe.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132015000100048&lng=en&tlng=enPneumoniaEfeitos psicossociais da doençaCustos e análise de custoCustos de cuidados de saúdeHospitalizaçãoÍndice de gravidade de doença
spellingShingle Vojislav Cupurdija
Zorica Lazic
Marina Petrovic
Slavica Mojsilovic
Ivan Cekerevac
Nemanja Rancic
Mihajlo Jakovljevic
Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity,
Jornal Brasileiro de Pneumologia
Pneumonia
Efeitos psicossociais da doença
Custos e análise de custo
Custos de cuidados de saúde
Hospitalização
Índice de gravidade de doença
title Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity,
title_full Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity,
title_fullStr Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity,
title_full_unstemmed Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity,
title_short Community-acquired pneumonia: economics of inpatient medical care vis-à-vis clinical severity,
title_sort community acquired pneumonia economics of inpatient medical care vis a vis clinical severity
topic Pneumonia
Efeitos psicossociais da doença
Custos e análise de custo
Custos de cuidados de saúde
Hospitalização
Índice de gravidade de doença
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132015000100048&lng=en&tlng=en
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