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The annual economic burden among patients hospitalized for community-acquired pneumonia (CAP): a retrospective US cohort study.

社区获得性肺炎 (CAP) 住院患者的年度经济负担: 一项回顾性美国队列研究。

  • 影响因子:2.02
  • DOI:10.1080/03007995.2019.1675149
  • 作者列表:"Divino V","Schranz J","Early M","Shah H","Jiang M","DeKoven M
  • 发表时间:2020-01-01
Abstract

:Objective: To assess the 1-year economic burden among patients hospitalized for community-acquired pneumonia (CAP) in the US.Methods: Adult patients hospitalized for CAP between 1/2012 and 12/2016 were identified from the IQVIA hospital charge data master (CDM) linked to the IQVIA Real-World Data Adjudicated Claims - US Database (date of admission = index date). Patients had continuous enrollment 180-days pre- and 360-days post-index, and empiric antimicrobial treatment (monotherapy [EM] or combination therapy [EC]) and chest x-ray on the index date or day after. All-cause and CAP-related healthcare resource utilization and cost were assessed over the 1-year follow-up. Generalized linear models (GLM) examined adjusted total cost.Results: The cohort comprised 1624 patients hospitalized for CAP (mean age 50.3; 52.8% female). The majority (78.2%) initiated EC, most frequently with beta-lactams + macrolides (30.4%). The index hospitalization was associated with a mean length of stay (LOS) of 5.7 days and mean cost of $17,736; 22.7% had a transfer to the intensive care unit (ICU). All-cause readmission rates at 30- and 180-days were 8.8% and 20.1%, respectively. Mean annual all-cause total cost was $61,928; one-third (33.8%, $20,954) was related to CAP. The primary cost driver was inpatient care, which accounted for more than half (56.0%) of total all-cause cost and 94.3% of total CAP-related cost. Mean total inpatient cost was significantly higher among EC versus EM patients ($37,106 versus $25,999, p = .0399). Adjusted mean total all-cause cost was $55,391.Conclusions: Patients hospitalized for CAP incurred a significant annual economic burden, driven substantially by the high cost of hospitalizations.

摘要

目的: 评估美国社区获得性肺炎 (CAP) 住院患者 1 年的经济负担。方法: 从 IQVIA hospital charge data master (CDM) 中识别出 1/2012-12/2016 因 CAP 住院的成人患者链接到 IQVIA 真实世界数据裁定索赔-美国数据库 (批准日期 = 索引日期)。患者连续入组前 180 天和后 360 天,以及经验性抗菌治疗 (单药治疗 [EM] 或联合治疗 [EC]) 和胸片在索引日期或后一天。在 1 年的随访中评估了全因和 CAP 相关的医疗资源利用和成本。广义线性模型 (GLM) 检查了调整后的总成本。结果: 该队列包括 1624 例因 CAP 住院的患者 (平均年龄 50.3 岁; 52.8% 为女性)。大多数 (78.2%) 启动 EC,最常见的是 β-内酰胺酶 + 大环内酯类 (30.4%)。指数住院与平均住院时间 (LOS) 5.7 天、平均费用 17,736 美元相关; 22.7% 的患者转入重症监护病房 (ICU)。30 天和 180 天的全因再入院率分别为 8.8% 和 20.1%。平均年全因总成本为 61,928 美元; 3分之1 (33.8%,20,954 美元) 与 CAP 相关。主要成本动因为住院治疗,占总全因成本的一半以上 (56.0%),占总 CAP 相关成本的 94.3%。EC 与 EM 患者的平均总住院费用显著高于 EM 患者 ($37,106 vs $25,999,p = 0399)。调整后的平均全因总费用为 55,391 美元。结论: 因 CAP 住院的患者每年承受重大经济负担,这主要是由高住院费用驱动的。

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影响因子:3.94
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作者列表:["Bernstein DM","Toth B","Rogers RA","Kling DE","Kunzendorf P","Phillips JI","Ernst H"]

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影响因子:4.04
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