title: Health care and social care costs of pneumonia in Denmark: a register-based study of all citizens and patients with COPD in three municipalities.
abstract: BACKGROUND
  Pneumonia is a frequent lung infection and a serious illness, which is often diagnosed among patients hospitalized with acute exacerbations of COPD. The aim of this study was to estimate the attributable costs due to pneumonia among patients hospitalized with pneumonia compared to a matched general population control group without pneumonia hospitalization.
  
  
  METHODS
  This study includes citizens older than 18 years from three municipalities (n=142,344). Based on national registers and municipal data, the health and social care costs of pneumonia in the second half of 2013 are estimated and compared with propensity score-matched population controls.
  
  
  RESULTS
  The average health care costs of 383 patients hospitalized with pneumonia in the second half of 2013 were US$34,561 per patient. Among pneumonia patients with COPD, the costs were US$35,022. The attributable costs of patients with pneumonia compared to the population control group for the 6-month period were US$24,155 per case. Overall, the attributable costs for the 383 pneumonia cases amounted to US$9.25 million. Subgroup analyses showed that costs increased with age. The attributable costs due to pneumonia were highest among the 18-59-year-old and the 70-79-year-old patients. This difference is likely to reflect an increased risk of mortality among the pneumonia patients. Men have higher costs than women in the pneumonia group.
  
  
  CONCLUSIONS
  The costs of pneumonia are considerable. In three Danish municipalities, the attributable costs due to pneumonia were US$24,155 per case or US$64,992 per 1,000 inhabitants in the second half of 2013. Similar high health care and social care costs were found for pneumonia patients with COPD - the largest group having pneumonia episodes. The municipalities are responsible for 49% of the costs, while a closer focus on the prevention of pneumonia may be advisable, eg, starting with citizens having COPD.
authors.affiliation: COWI AS, Management - Health, Kongens Lyngby, Denmark.
authors.forename: Susanne Lausten
authors.initials: SL
authors.lastname: Brogaard
authors.affiliation: COWI AS, Management - Health, Kongens Lyngby, Denmark.
authors.forename: Maj Britt Dahl
authors.initials: MB
authors.lastname: Nielsen
authors.affiliation: Seniors and Health Department, Gladsaxe Municipality, Welfare Technology, Søborg, Denmark.
authors.forename: Lars Ulrik
authors.initials: LU
authors.lastname: Nielsen
authors.affiliation: Elderly and Health Care Department, Lolland Municipality, Maribo, Denmark.
authors.forename: Trine Mosegaard
authors.initials: TM
authors.lastname: Albretsen
authors.affiliation: Department of Public Health, Holbaek Municipality, Holbaek, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Bundgaard
authors.affiliation: COWI AS, Management - Health, Kongens Lyngby, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Anker
authors.affiliation: COWI AS, Management - Health, Kongens Lyngby, Denmark.
authors.forename: Maja
authors.initials: M
authors.lastname: Appel
authors.affiliation: COWI AS, Management - Health, Kongens Lyngby, Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Gustavsen
authors.affiliation: Pfizer Denmark ApS, Health & Value, Ballerup, Denmark.
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Lindkvist
authors.affiliation: Seniors and Health Department, Gladsaxe Municipality, Welfare Technology, Søborg, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Skjoldan
authors.affiliation: Elderly and Health Care Department, Lolland Municipality, Maribo, Denmark.
authors.forename: Grete
authors.initials: G
authors.lastname: Breinhild
authors.affiliation: Pfizer Denmark ApS, Health & Value, Ballerup, Denmark.
authors.forename: Peter Bo
authors.initials: PB
authors.lastname: Poulsen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002947:Cities / Q000191:economics*; D017281:Cost of Illness; D003718:Denmark / Q000453:epidemiology; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D057216:Propensity Score; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D012042:Registries; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors; D019037:Urban Health Services / Q000191:economics*; D055815:Young Adult
keywords: COPD; attributable costs; health care; municipalities; pneumonia; social care