Published in:
01-08-2004 | Original Research Article
Resource Use and Cost of Care for Patients Hospitalised with Community Acquired Pneumonia
Impact of Adherence to Infectious Diseases Society of America Guidelines
Published in: PharmacoEconomics | Issue 11/2004
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Objective: The objective of this study was to compare the inpatient resource use and cost of care for patients hospitalised with community-acquired pneumonia (CAP) who were treated with preferred antibacterial therapy according to the 1998 Infectious Diseases Society of America (IDSA) guidelines with those who were not treated with preferred therapy.
Methods: A multicentre, observational study was conducted in Florida between 1999 and 2000. Hospitalised adult patients (aged ≥18 years) started on antibacterial therapy for suspected or confirmed CAP were enrolled in the study. Data collected included patient demographic characteristics, pneumonia risk class, resource use (pharmacy, laboratory, radiology, respiratory services, hospital room and board) and economic data. Risk classification according to Fine et al.’s criteria was determined for each patient. Patient’s antibacterial therapy was classified as being preferred or non-preferred according to the 1998 IDSA guidelines. Resource utilisation and cost of care were compared between these two groups.
Results: Ninety-nine patients were enrolled in the study. The average age was 60.6 years ± 20.5 years. The percentage of patients in each risk class (according to Fine et al.) were 11.1% in class I, 39.4% in class II, 29.3% in class III, 16.2% in class IV and 4% in class V.
The mean cost of hospitalisation per admission (excluding physician cost) was $US3490 ± $US3058 (median $US2430) with hospital room/board accounting for the largest percentage (83.7%), followed by laboratory (8.1%), antibacterial (4.6%), radiology (2.6%) and respiratory (0.9%) cost centres [year 2000 values].
The majority of patients (75.8%) received preferred antibacterials according to the IDSA guidelines. The group treated with preferred antibacterials had a shorter mean length of hospital stay (4.5 vs 6.8 days, p = 0.002), a lower total cost of hospitalisation (mean $US3009 ± $US2682 vs $US4992 ± $US3686; median $US2047 vs $US3805, p = 0.021) and lower antibacterial costs (mean $US117 ± $US79 vs $US301 ± $US409; median $US97 vs $US171, p = 0.038) compared with patients who did not receive preferred therapy.
Conclusion: Implementation of protocols according to IDSA guidelines may result in cost savings to institutions wishing to reduce the economic burden associated with treating hospitalised patients for CAP.