THE COST OF TREATING COMMUNITY-ACQUIRED PNEUMONIA

Community-acquired pneumonia (CAP) is responsible for an average of 4. 5 million visits annually to physicians' offices, emergency department s, and outpatient clinics. However, there have been few studies using national data on the costs of treating CAP. Without such data, it is d ifficult to assess whether new therapies and treatment strategies are needed to improve patient outcomes. We conducted a retrospective analy sis based on national incidence data and paid claims data for patients treated for CAP to assess the frequency of services rendered and cost s to the health-care system. Records were selected for the study based on a primary diagnosis of CAP according to the International Classifi cation of Diseases, 9th Revision. Incidence data were derived from the National Health and Nutrition Examination Survey III. Medicare was th e primary source of data for patients aged greater than or equal to 65 years. Data from the National Health-care Cost and Utilization Projec t, the National Ambulatory Medical Care Survey, and the National Hospi tal Ambulatory Medical Care Survey were used to determine the cost of treating patients aged <65 years. We arrived at a total cost of $4.8 b illion for treating patients aged greater than or equal to 65 years an d $3.6 billion for treating patients aged <65 years. These calculation s were based on the following: 1.1 million hospital discharges resulti ng in inpatient costs of $4.4 billion (52.4% of the $8.4 billion) for the 0.6 million patients aged greater than or equal to 65 years and $3 .1 billion (36.9% of the $8.4 billion) for the 0.5 million patients ag ed <65 years. The average hospital length of stay was 7.8 days with an average cost of $7166 for patients aged greater than or equal to 65 y ears and 5.8 days with an average cost of $6042 for younger patients. Room and board represented the largest percentage of the average hospi tal bill for patients with CAP. Inpatient physician service costs were $305 million and $192 million for the greater than or equal to 65 and <65 groups, respectively. Based on 1.1 million outpatient office visi ts for those aged greater than or equal to 65 years and 3.3 million vi sits for those aged <65, total outpatient costs were $119 million and $266 million, respectively. Given the overwhelming cost burden for CAP in the hospital setting, any new therapy that allows patients to be t reated in the outpatient setting could result in significant savings, especially for patients aged greater than or equal to 65 years.