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Economic burden of community-acquired pneumonia among elderly patients: a Japanese perspective

机译：日本人的观点：老年患者社区获得性肺炎的经济负担

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Background This study aimed to estimate the economic burden of community-acquired pneumonia (CAP) among elderly patients in Japan. In addition, the study evaluated the relationship between total treatment cost and CAP risk factors. Methods An administrative database was searched for elderly patients (≥ 65?years old) who had pneumonia (ICD-10 code: J12–J18) and an antibiotic prescription between 1 June 2014 and 31 May 2015. The all-cause total healthcare costs of outpatient and inpatient CAP episodes were calculated. Results This study evaluated data from 29,619 patients with CAP who experienced 14,450 outpatient CAP episodes and/or 20,314 inpatient CAP episodes. The mean ages were 77.5?±?8.0?years and 81.5?±?8.2?years among the outpatient and inpatient groups, respectively. The median treatment costs were US$346 (interquartile range: $195–551) per outpatient episode and US$4851 (interquartile range: $3313–7669) per inpatient episode. More severe cases had increased treatment costs at the treating hospitals. Male sex, diabetes, chronic obstructive pulmonary disease, and liver dysfunction were associated with increased total treatment costs, while dementia, dialysis, and rheumatism were associated with high costs of treating a CAP episode. Conclusions The economic burden of CAP might be decreased by reducing the number of hospitalizations for mild CAP and the incidence of severe CAP. Therefore, preventative care (e.g. oral hygiene or pneumococcus vaccination) is recommended for patients with related risk factors, such as male sex, older age, diabetes, chronic obstructive pulmonary disease, liver dysfunction, rheumatism, dementia, or dialysis.
机译：背景技术这项研究旨在评估日本老年患者社区获得性肺炎（CAP）的经济负担。此外，该研究评估了总治疗费用与CAP危险因素之间的关系。方法检索2014年6月1日至2015年5月31日期间患有肺炎（ICD-10代码：J12–J18）和抗生素处方的老年患者（≥65岁）的行政数据库。计算了门诊和住院CAP事件。结果本研究评估了29,619名CAP患者的数据，这些患者经历了14,450例门诊CAP发作和/或20,314例住院CAP发作。门诊和住院组的平均年龄分别为77.5±8.0岁和81.5±8.2岁。平均每次门诊治疗费用为346美元（四分位间距：195–551美元），每次住院的治疗费用中位数为4851美元（四分位间距：3313–7669美元）。更严重的病例增加了治疗医院的治疗费用。男性，糖尿病，慢性阻塞性肺疾病和肝功能障碍与总治疗费用增加相关，而痴呆，透析和风湿病与治疗CAP发作的高费用相关。结论通过减少轻度CAP的住院次数和重度CAP的发病率，可以减轻CAP的经济负担。因此，建议对具有相关风险因素的患者进行预防保健（例如口腔卫生或肺炎球菌疫苗接种），例如男性，老年人，糖尿病，慢性阻塞性肺疾病，肝功能不全，风湿病，痴呆或透析。

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