Clinical and economic burden of community-acquired pneumonia in the Veterans Health Administration, 2011: a retrospective cohort study.
Clinical and economic burden of community-acquired pneumonia in the Veterans Health Administration, 2011: a retrospective cohort study.
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DOI：
10.1007/s15010-015-0789-3
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发表时间：
2015-12
期刊：
影响因子：
7.5
通讯作者：
Baer SL
中科院分区：
文献类型：
--
作者：
McLaughlin JM;Johnson MH;Kagan SA;Baer SL
美国退伍军人健康管理局 (VHA) 没有很好地描述社区获得性肺炎 (CAP) 的负担。 CAP 的定义是有胸部 X 光检查证据的肺炎诊断，并且没有先前（90 天）住院/长期护理的证据。我们计算了 2011 年 VHA 住院或门诊成人 CAP 的发病率。我们还估计了住院、出院 30 天内再次入院以及诊断后一年内死亡（任何原因）的 VHA CAP 患者的比例。 CAP 诊断后 90 天内的增量费用是从 VHA 的角度进行估算的。 2011 年，超过 7,739,757 人年的 VHA 中有 34,101 名退伍军人患上 CAP（35,380 次发作）。 CAP 患者的中位年龄为 65 岁（95% 为男性）。年龄≥50 岁的人 CAP 发病率较高。大多数 50-64 岁 (53%) 和 65 岁以上 (66%) 的退伍军人患有 ≥1 种慢性疾病（中度风险）或免疫功能低下（高风险）疾病。与低风险（健康）的退伍军人相比，中风险和高风险退伍军人患 CAP 的可能性分别高出 3 倍和 6 倍以上。住院的 CAP 患者比例为 45%，范围从 12%（18-49 岁，低风险）到 57%（年龄 ≥65 岁，高风险）。一年全因死亡率范围为 1%（18-49 岁，低风险）到 36%（年龄 ≥65 岁，高风险）。与 CAP 相关的年度 VHA 医疗支出估计为 7.5 亿美元（对于年龄≥65 岁的人为 4.15 亿美元）。重点关注老年退伍军人和患有合并症或免疫功能低下疾病的人的 CAP 预防非常重要。本文的在线版本 (doi:10.1007/s15010-015-0789-3) 包含补充材料，可供授权用户使用。
The burden of community-acquired pneumonia (CAP) is not well described in the US Veterans Health Administration (VHA). CAP was defined as having a pneumonia diagnosis with evidence of chest X-ray, and no evidence of prior (90 days) hospitalization/long-term care. We calculated incidence rates of adult CAP occurring in inpatient or outpatient VHA settings in 2011. We also estimated the proportion of VHA CAP patients who were hospitalized, were readmitted within 30 days of hospital discharge, and died (any cause) in the year following diagnosis. Incremental costs during the 90 days following a CAP diagnosis were estimated from the perspective of the VHA. In 2011, 34,101 Veterans developed CAP (35,380 episodes) over 7,739,757 VHA person-years. Median age of CAP patients was 65 years (95 % male). CAP incidence rates were higher for those aged ≥50 years. A majority of Veterans aged 50–64 (53 %) and ≥65 (66 %) years had ≥1 chronic medical (moderate risk) or immunocompromising (high risk) condition. Compared to those at low-risk (healthy), moderate- and high-risk Veterans were >3 and >6 times more likely to develop CAP, respectively. The percentage of CAP patients who were hospitalized was 45 %, ranging from 12 % (age 18–49, low risk) to 57 % (age ≥65, high risk). One-year all-cause mortality rates ranged from 1 % (age 18–49, low risk) to 36 % (age ≥65, high risk). Annual VHA medical expenditure related to CAP was estimated to be $750 million (M) ($415M for those aged ≥65 years). A focus on CAP prevention among older Veterans and those with comorbid or immunocompromising conditions is important. The online version of this article (doi:10.1007/s15010-015-0789-3) contains supplementary material, which is available to authorized users.