HOSPITALIZATION FOR PNEUMONIA AMONG OLDER ADULTS

Background. Hospitalizations and mortality due to pneumonia increase s teadily with age. The purpose of this study is to describe the frequen cy, costs, and risk factors for hospitalization for pneumonia among ol der adults with particular attention to the effect of functional disab ility. Methods. The Longitudinal Study of Aging (LSOA) is the follow-u p to the Supplement on Aging, which was appended to the 1984 National Health Interview Survey. Participants included a nationally representa tive sample of 7,527 community-dwelling adults aged 70 and older in 19 84 who were followed prospectively for 8 years. The LSOA data are link ed to the National Death Index and to yearly abstracts from the Medica re Automated Data Retrieval System (1984-1991). Results. From 1984 to 1991, 617 subjects (8.2%) had at least one hospitalization for pneumon ia, 4,333 (57.5%) had at least one hospitalization for any reason, and 2,867 (38.1%) of the LSOA subjects died. The yearly frequency of hosp italization for pneumonia increased over time from 0.6% in 1984 to 2.4 % in 1991. The median length of stay was 8 days, and the median hospit al charge was $5,100. Over 8 years, median discounted charges for a pn eumonia hospitalization increased 75% while length of stay remained re latively constant. Patients hospitalized for pneumonia had greater com orbidity, total hospital resource use, and mortality, but over 80% sur vived their first hospitalization for pneumonia. Hospitalization for p neumonia was associated with age, male gender, malnutrition, history o f hip fracture, prior hospitalizations, and lower body limitations. Co nclusions. Hospitalization for pneumonia was frequent and accounted fo r 6% of the Medicare expenditures over 8 years among this cohort of ol der adults. Hospitalization for pneumonia occurred most often among su bjects with prior evidence of failing health, but most subjects surviv ed the first hospitalization for pneumonia. Even controlling for comor bidity, prior hospitalizations, and functional impairment, hospitaliza tion for pneumonia was independently associated with age.