Direct cost of treatment in hospitalized community- acquired pneumonia patients

Abstract

Treatment of   community acquired pneumonia (CAP) puts an extensive burden on hospitals resources. The aim of the study was to determine direct medical cost of treatment in hospitalized community acquired pneumonia patients. The study was a prospective, observational study involving 258 patients with age group >1 year of age and less than 90 years of age. Direct medical cost (ward cost, medication cost and diagnostic tests cost) was assessed. The influence of co-morbidity and severity of disease were analyzed on direct medical cost associated with hospitalized CAP patients. The study was conducted in a 350-bed hospital situated in central district of Karachi. The cost study was conducted from hospital perspective. Patient with co morbid condition, higher severity index and higher age experienced higher cost. Co-morbidity was found in 45.35% patient. The median total cost was PK Rupees 12163 and the component of costs was:  ward cost PK Rupees 7200 diagnosis cost PK Rupees 1310, medication cost PK Rupees 3679. A descriptive analysis approach was used to analyze clinical management, clinical outcome and healthcare resources. All data were analyzed using SPSS 15 version and spearman correlation was used to determine correlation. A positive correlation was found between the total cost (γ=0.486), p=0.000) as well as the cost of each component and the PSI i.e. the higher the risk class, the greater the cost. In conclusion, medication, diagnostic procedures and length of stay in hospital are the important component of cost of treatment of hospitalized CAP patient. Patient with higher age, co morbidity and higher length of stay experienced higher cost. The cost increases as the severity of the disease increases. Strategies designed to ensure correct medication use, early management of associated co morbidity, may help in decreasing in-patient costs in hospitalized patient of community-acquired pneumonia.