Korean J Intern Med.  2014 Nov;29(6):764-773. 10.3904/kjim.2014.29.6.764.

Disease burden of pneumonia in Korean adults aged over 50 years stratified by age and underlying diseases

Affiliations
  • 1Department of Internal Medicine, Konkuk University Chungju Hospital, Chungju, Korea.
  • 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  • 3Outcomes Research/Evidence Based Medicine Team, Market Access Department, Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea.
  • 4Division of Pulmonary Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 5Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea. khyou@kuh.ac.kr

Abstract

BACKGROUND/AIMS
This study was conducted to assess the disease burden of pneumonia according to age and presence of underlying diseases in patients admitted with community-acquired pneumonia (CAP).
METHODS
We performed a retrospective, observational study and collected data targeting patients with CAP (> or = 50 years) from 11 hospitals. Disease burden was defined as total per-capita medical fee, severity (CURB-65), hospital length of stay (LOS), and mortality.
RESULTS
Of the 693 enrolled subjects, elderly subjects (age, > or = 65 years) had a higher mean CURB-65 score (1.56 vs. 0.25; p < 0.01) and higher mortality than nonelderly subjects (4.4% [n = 21] vs. 0.5% [n = 1]; p = 0.00). In addition, the total cost of pneumonia treatment was higher in elderly patients compared to in nonelderly patients (KRW 2,088,190 vs. US $1,701,386; p < 0.01). Those with an underlying disease had a higher CURB-65 score (1.26 vs. 0.68; p < 0.01), were much older (mean age, 71.24 years vs. 64.24 years; p < 0.01), and had a higher mortality rate than those without an underlying disease (3.5% [n = 20] vs. 1.7% [n = 2]; p = 0.56). Total per-capita medical fees were higher (KRW 2,074,520 vs. US $1,440,471; p < 0.01) and hospital LOS was longer (mean, 8.38 days vs. 6.42 days; p < 0.01) in patients with underlying diseases compared to those without.
CONCLUSIONS
Due to the relatively high disease burden in Korea, particularly in the elderly and in those with an underlying disease, closer and more careful observation is needed to improve the outcomes of patients with CAP.

Keyword

Pneumonia; Costs and cost analysis; Comorbidity; Age factors

MeSH Terms

Age Distribution
Age Factors
Aged
Aged, 80 and over
Community-Acquired Infections/diagnosis/economics/*epidemiology/mortality/therapy
Comorbidity
Costs and Cost Analysis
Female
Health Care Costs
Hospitalization
Humans
Length of Stay
Male
Middle Aged
Pneumonia/diagnosis/economics/*epidemiology/mortality/therapy
Republic of Korea/epidemiology
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
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