A Cost-Of-Illness Analysis For Community Acquired Pneumonia In Greece

• Published in: Value in health Vol. 20; no. 9; p. A642
• Main Authors: Naoum, P, Liapikou, A, Toumbis, M, Athanasakis, K, Kyriopoulos, J
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.10.2017
• Subjects: Chest; Clinical outcomes; Diagnostic tests; Discharge; Drugs; Emergency services; Health care expenditures; Hospitalization; Hospitals; Inpatient care; Length of stay; Medical treatment; Outpatients; Pneumonia; Greece
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.1474

OBJECTIVES: Community acquired pneumonia (CAP) is accompanied by a high clinical and economic burden, especially when patients' condition requires hospitalization. The purpose of the present analysis was to estimate the mean direct outpatient and inpatient cost of CAP episodes in Greece. METHODS: Data were collected from the Emergency Department of the Sotiria Chest Diseases Hospital For CAP outpatients, data on diagnostic tests, number of physician visits and medication were collected, while for inpatients, data included diagnostic tests, medication, length of hospital stay, additional tests during hospitalization and discharge instructions. Moreover, it was recorded whether patients of both groups returned for reassessment and if so, whether additional tests and medication were provided. Cost calculations were performed from a third payer perspective (direct costs only) and refer to 2016. RESULTS: Overall, 249 patients were included in the analysis, 149 inpatients and 100 outpatients, with a mean age of 55.1 years (SD= 18.764). Mean length of hospital stay was calculated at 11.35 days (SD=9.71). For outpatients, mean direct cost was estimated at 110.64€ (SD=58.23) per patient, while for inpatients at 7,406.56€ (SD=12,124.93) per patient. The main driver of the inpatient cost was hospitalisation (94.97%), followed by medication during hospitalisation (3.30%) and diagnostic tests (0.87%). For outpatients, prescribed medication represented the highest proportion of total cost (38.84%), followed by diagnostic tests (33.51%) and physician visits (17.54%). CONCLUSIONS: CAP imposes a high economic burden on the Greek healthcare system, mainly due to the cost of hospitalisation. Further investigation is required to identify the reasons of the high hospitalisation rates and duration observed in Greece, in order to improve patient management models and reduce, when possible, inpatient care, while maintaining optimum clinical outcomes.