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Economic
Burden of Pneumonia in an Employed Population
Although the direct costs for treating pneumonia are known to be
high, employers may be significantly underestimating the total financial
burden of pneumonia, especially by overlooking the indirect (spill-over
or shared) costs. This observation is meaningful clinically, as well,
in terms of treatments for other problems that are related to the pneumonia.
Medical,
pharmaceutical, and disability claims data were used to determine the
annual per capita cost of pneumonia for beneficiaries of a Fortune 100
company. These costs were compared with a random sample of beneficiaries
without pneumonia from the same employee population.
- Annual
costs for the pneumonia patients were about 5X other workers
- The majority
of the pneumonia-related costs was in about 10% of the patients
- For
every $1 spent on pneumonia health care costs, the employer spent another
$12 on direct and indirect costs related to the worker's pneumonia
Conclusion:
failure to properly account fully for these broader consequences of pneumonia
could result in a significant underassessment of the cost of pneumonia
to employers.
Birnbaum
HG, Morley M, Greenberg PE, Cifaldi M, Colice GL. Economic Burden of Pneumonia
in an Employed Population Arch Intern Med. December 10/24, 2001;161(22):2725-2731
Promising
Research Findings for Clinicians--Pneumonia
Prediction Model
Every year, about 600,000 of the 4 million Americans who develop community-acquired
pneumonia (CAP) are hospitalized. However, because of a dearth of evidence-based
admission criteria, coupled with a common tendency to overestimate the
risk of death, many low-risk patients could safely be treated as outpatients
and instead are admitted for more costly inpatient care.
The investigators of this study suggest that if the Fein protocol of model
had been used, "26-31% of the patients who were hospitalized for
care could have been treated safely as outpatients, and an additional
13-19% could have been hospitalized only briefly for observation."
The investigators made projections from a prospective cohort study of
2,287 CAP patients in Pittsburgh, Boston, and Halifax, Nova Scotia, and
they validated the model for accuracy and general applicability with data
on over 50,000 CAP patients in 275 U.S. and Canadian hospitals."
For Consumers:
More
Patients Can Be Treated at Home
References:
a partial list of studies from the Pneumonia PORT [AHCPR #97-R031,
Jan 1997] (shown in reverse chronological order):
Fine MJ, Auble TE, Yealy DM, et al. A prediction rule to identify low-risk
patients with community-acquired pneumonia. The New England Journal
of Medicine 1997 (January 23); 336:243-250.
Fine MJ, Hough LJ, Medsger AR, et al. The hospital admission decision
for patients with community-acquired pneumonia: Results from the Pneumonia
PORT. Archives of Internal Medicine 1997 (January 13); 157:36-44.
Fine MJ, Medsger AR, Stone RA, et al. The hospital discharge decision
for patients with community-acquired pneumonia: Results from the Pneumonia
PORT. Archives of Internal Medicine 1997 (January 13); 157:47-56.
Coley CM, Li YH, Medsger AR, et al. Preferences for home versus hospital
care among low-risk patients with community-acquired pneumonia. Archives
of Internal Medicine 1996 (July 22); 156:1565-1571.
Minogue MF, Hough LJ, Fine MJ, et al. Patients hospitalized after initial
ambulatory therapy for community-acquired pneumonia. Journal of General
Internal Medicine 1996 (April); 11(supplement 1):52A.
Fine MJ, Smith MA, Carson CA, et al. Prognosis and outcomes of patients
with community-acquired pneumonia: A meta-analysis. The Journal of
the American Medical Association 1996 (January 10); 275:2.
Cassiere & Fein - in Medscape
1(9),1997
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