Trends in Mortality and Medical Spending in Patients Hospitalized for Community-Acquired Pneumonia: 1993–2005

DSpace/Manakin Repository

Trends in Mortality and Medical Spending in Patients Hospitalized for Community-Acquired Pneumonia: 1993–2005

Citable link to this page

. . . . . .

Title: Trends in Mortality and Medical Spending in Patients Hospitalized for Community-Acquired Pneumonia: 1993–2005
Author: Ruhnke, Gregory W.; Coca-Perraillon, Marcelo; Kitch, Barrett Tyler; Cutler, David M.

Note: Order does not necessarily reflect citation order of authors.

Citation: Ruhnke, Gregory W., Marcelo Coca-Perraillon, Barrett T. Kitch, and David M. Cutler. 2010. Trends in mortality and medical spending in patients hospitalized for community-acquired pneumionia: 1993-2005. Medical Care 48(12): 1111-1116.
Full Text & Related Files:
Abstract: Background: Community-acquired pneumonia (CAP) is the most common infectious cause of death in the United States. To understand the impact of efforts to improve quality and efficiency of care in CAP, we examined trends in mortality and costs among hospitalized CAP patients. Methods: Using the National Inpatient Sample from 1993–2005, we studied 569,524 CAP admissions. The primary outcome was mortality at discharge. We used logistic regression to evaluate the mortality trend, adjusting for age, gender, and comorbidities. To account for the impact of early discharge practices, we also compared daily mortality rates and performed a Cox proportional-hazards model. We used a generalized linear model to analyze trends in hospitalization costs, which were derived using cost-to-charge ratios. Results: Over time, length of stay (LOS) declined, while more patients were discharged to other facilities. The frequency of many comorbidities increased. Age/gender-adjusted mortality decreased from 8.9% to 4.1% (P < 0.001). In multivariable analysis, the mortality risk declined through 2005 (odds ratio, 0.50; 95% confidence interval [CI], 0.48–0.53), compared to reference year 1993. The daily mortality rates demonstrated that most of the mortality reduction occurred early during hospitalization. After adjusting for early discharge practices, the risk of mortality still declined through 2005 (hazard ratio, 0.74, 95% CI 0.70–0.78). Median hospitalization costs exhibited a modest reduction over time, mostly due to reduced LOS. Conclusions: Mortality among patients hospitalized for CAP has declined. Lower in-hospital mortality at a reduced cost suggests that pneumonia is a case of improved productivity in health care.
Published Version: doi:10.1097/MLR.0b013e3181f38006
Other Sources: http://www.ncbi.nlm.nih.gov/pubmed/21063230
Terms of Use: This article is made available under the terms and conditions applicable to Open Access Policy Articles, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#OAP
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:5344530

Show full Dublin Core record

This item appears in the following Collection(s)

  • FAS Scholarly Articles [6948]
    Peer reviewed scholarly articles from the Faculty of Arts and Sciences of Harvard University
 
 

Search DASH


Advanced Search
 
 

Submitters