High pneumonia incidence ups elderly COPD medical costs

By Sara Freeman, medwireNews Reporter

Older individuals with chronic obstructive pulmonary disease (COPD) are almost six times more likely to develop pneumonia and eight times more likely to need hospital treatment than those without the disease, US researchers have found.

This significantly increases the direct medical costs for up to 2 years after hospitalization, say Marian Ryan (Brandeis University, Waltham, Massachusetts) and colleagues and has implications for healthcare policy.

“Acute exacerbations due to pneumonia that result in hospitalizations and readmissions are the major contributors to the economic burden of COPD,” Ryan et al write in Plos One.

They explain: “Although the incidence and cost of pneumonia in the elderly has been documented, less is know about the incidence and economic impact of pneumonia in elderly individuals with underlying COPD.”

In their retrospective, longitudinal study of 1,565,638 individuals aged 65 years or older, the team found that the incidence of pneumonia was 167.6/1000 person-years in those with COPD and 29.5/1000 person-years in those without COPD (relative risk [RR]=5.7).

And, the incidence of pneumonia requiring hospitalization was 54.2/1000 person-years compared with 7/1000 person-years for individuals with and without COPD (RR=7.7).

The researchers also found that the risk for pneumonia and for hospitalization was increased in those who had concomitant congestive heart failure when compared with those without COPD.

The team calculated that the direct medical cost of treating inpatient pneumonia from the time of hospitalization to 2 years afterwards was an extra US$28,638 (€21,160) for patients with COPD compared with those without COPD.

The excess cost was highest in the first few months of hospitalization and totalled an additional $22,697 (€16,700) over the course of the first year and $5,941 (€4,380) over the course of the second year.

“COPD and pneumonia are high cost conditions individually and concomitantly, pneumonia and COPD increase health care cost synergistically in the elderly,” Ryan et al state.

They suggest that use of therapies specifically aimed at preventing pneumonia “may have a beneficial impact on health utilization and cost.”

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