Cost analyses of community-acquired pneumonia from the hospital perspective.
OBJECTIVE
Community-acquired pneumonia (CAP) is a widespread disease with important implications for health-care systems worldwide. This study investigated direct costs, treatment patterns, and outcomes associated with two patient cohorts hospitalized with CAP.


METHODS
The study design was naturalistic, prospective, and open.


METHODS
The study enrolled 580 patients. Two hundred sixty-one patients were treated initially with IV moxifloxacin (45%, cohort M); the remaining 319 patients received nonstandardized treatment (cohort S).


METHODS
Twenty-two hospitals in Germany.


RESULTS
Clinical success rates were similar between treatment groups (cohort M, 242 of 256 patients, 95%; cohort S, 286 of 312 patients, 92%; p = 0.208). Mean +/- SD length of hospital stay was 10.8 +/- 5.2 days, with cohort M having a significantly shorter hospital stay (10.0 +/- 4 days) compared to cohort S (11.5 +/- 6 days; p < 0.001). Median of all direct costs was dollar 1,333 (minimum, dollar 127; maximum, dollar 9,488), with direct costs of dollar 1,250 in cohort M (minimum, dollar 372; maximum, dollar 9,488) and dollar 1,409 in cohort S (minimum, dollar 127; maximum, dollar 9,366) per treated episode of CAP (p = 0.066).


CONCLUSIONS
Major determinants of costs were length of hospital stay and ICU admission, whereas costs for staff and hotel were major contributors to direct costs. Initial antibiotic therapy with moxifloxacin resulted in similar clinical efficacy and direct costs compared to nonstandardized therapy; however, patients treated with moxifloxacin benefited with an earlier hospital discharge.
Bauer
Torsten Thomas
TT
Department of Internal Medicine III, University Hospital Bergmannsheil, Bochum, Germany. torsten.bauer@rub.de
Welte
Tobias
T
Ernen
Carolin
C
Schlosser
Barbara Monika
BM
Thate-Waschke
Inga
I
de Zeeuw
Justus
J
Schultze-Werninghaus
Gerhard
G
D000368:Aged; D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D001372:Aza Compounds / Q000191:economics / Q000627:therapeutic use; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000191:economics*; D015897:Comorbidity; D003365:Costs and Cost Analysis; D005260:Female; D024841:Fluoroquinolones; D005858:Germany; D006764:Hospitals, Community / Q000191:economics*; D006801:Humans; D008297:Male; D000077266:Moxifloxacin; D011014:Pneumonia / Q000191:economics*; D011804:Quinolines / Q000191:economics / Q000627:therapeutic use; D012907:Smoking / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin