title: Assessing the burden of pneumonia using administrative data from Malaysia, Indonesia, and the Philippines.
abstract: OBJECTIVE
  To describe the incidence, mortality, cost, and length of stay (LOS) of hospitalized community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in three Southeast Asian countries: Malaysia, Indonesia, and the Philippines.
  
  
  METHODS
  Using Casemix system data from contributing hospitals, patients with International Classification of Diseases 10(th) revision (ICD-10) codes identifying pneumonia were categorized into CAP or HAP using a logical algorithm. The incidence among hospitalized patients, case fatality rates (CFR), mean LOS, and cost of admission were calculated. The population incidence was calculated based on Malaysian data.
  
  
  RESULTS
  For every 100000 discharges, CAP and HAP incidences were 14245 and 5615 cases, respectively, in the Philippines, 4205 and 2187, respectively, in Malaysia, and 988 and 538, respectively, in Indonesia. The impact was greatest in the young and the elderly. The CFR varied from 1.4% to 4.2% for CAP and from 9.1% and 25.5% for HAP. The mean LOS was 6.1-8.6 days for CAP and 6.9-10.2 days for HAP. The cost of hospitalization was between USD 254 and USD 1208 for CAP and between USD 275 and USD 1482 for HAP.
  
  
  CONCLUSIONS
  The burden of CAP and HAP is high. Results varied between the three countries, likely due to differences in socio-economic conditions, health system differences, and ICD-coding practices.
authors.affiliation: Azmi Burhani Consulting, Metropolitan Square, W103A, Jalan PJU 8/1, Damansara Perdana, 47820 Petaling Jaya, Selangor, Malaysia. Electronic address: soraya.azmi@azmi-burhani.com.
authors.forename: Soraya
authors.initials: S
authors.lastname: Azmi
authors.affiliation: International Centre for Casemix and Clinical Coding, UKM Medical Centre, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia; Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait City, Kuwait.
authors.forename: Syed Mohamed
authors.initials: SM
authors.lastname: Aljunid
authors.affiliation: Department of Health Management, Faculty of Health Science, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Namaitijiang
authors.initials: N
authors.lastname: Maimaiti
authors.affiliation: United Nations University - International Institute for Global Health, Kuala Lumpur, Malaysia.
authors.forename: Al-Abed
authors.initials: AA
authors.lastname: Ali
authors.affiliation: United Nations University - International Institute for Global Health, Kuala Lumpur, Malaysia.
authors.forename: Amrizal
authors.initials: A
authors.lastname: Muhammad Nur
authors.affiliation: Department of Health Philippines, Manila, Philippines.
authors.forename: Madeleine
authors.initials: M
authors.lastname: De Rosas-Valera
authors.affiliation: Health Policy Development Program, Ministry of Health, Manila, Philippines.
authors.forename: Joyce
authors.initials: J
authors.lastname: Encluna
authors.affiliation: Science University of Malaysia, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Rosminah
authors.initials: R
authors.lastname: Mohamed
authors.affiliation: National Centre for Casemix, Ministry of Health Indonesia, Jakarta, Indonesia.
authors.forename: Bambang
authors.initials: B
authors.lastname: Wibowo
authors.affiliation: Centre for Health Financing and Insurance, Ministry of Health Indonesia, Jakarta, Indonesia.
authors.forename: Kalsum
authors.initials: K
authors.lastname: Komaryani
authors.affiliation: Pfizer Inc., Collegeville, Pennsylvania, USA.
authors.forename: Craig
authors.initials: C
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D017714:Community-Acquired Infections / Q000453:epidemiology*; D017281:Cost of Illness; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007902:Length of Stay; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010679:Philippines / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: Burden of disease; CAP; Cost; HAP; Incidence rate; LOS