Abstract
Objectives
Pneumocost is a prospective study that aimed at documenting the costs of the management of patients hospitalized with a pneumococcal pneumonia and the post-discharge costs during a 6-month period in the French context.
Methods
Billing data were used to document hospital costs. Resource use during the follow-up period was collected through phone interviews at month 1, 3 and 6. Descriptive statistics and multivariate analyses were performed. We used generalized linear models with log-link functions to estimate parameters associated with hospital and follow-up costs of patients.
Results
Five hundred twenty-four patients were enrolled in 40 public centers from October 2011 to April 2014. Average age was 63 (SD 17); 55.0% of them were male. Average length of stay was 15 days (SD 23). Average cost of stay for the French Sickness Fund was €7293 (SD €7363). Average cost of follow-up was €1242 (SD €3000) and decreased steadily through time. When controlling for patient’s socioeconomic characteristics, severity of disease and hospital stay, results showed a concave relationship between hospital costs and age. Obesity, the severity of the disease and comorbidities were associated with constantly increasing inpatient costs. Concerning follow-up costs, we found the same concave relationship with age, while gender, a history of pneumonia and severity of the disease were the most important predictors of high costs after discharge.
Conclusion
Pneumocost is the first French study providing a robust estimation of the cost of managing invasive pneumococcal pneumonia in the French context.
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References
Torres, A., Peetermans, W.E., Viegi, G., Blasi, F.: Risk factors for community-acquired pneumonia in adults in Europe: a literature review. Thorax 68(11), 1057–1065 (2013)
Vila-Corcoles, A., Ochoa-Gondar, O., Rodriguez-Blanco, T., Raga-Luria, X., Gomez-Bertomeu, F.: EPIVAC study group. Epidemiology of community-acquired pneumonia in older adults: a population-based study. Respir. Med. 103(2), 309–316 (2009)
Trotter, C.L., Stuart, J.M., George, R., et al.: Increasing hospital admissions for pneumonia, England. Emerg. Infect. Dis. 14, 72733 (2008)
Welte, T., Torres, A., Nathwani, D.: Clinical and economic burden of community-acquired pneumonia among adults in Europe. Thorax 67, 71–79 (2012)
Casez, P., Fauconnier, J., Jorgensen, L., Gutterman, E.M., Gray, S., Munson, S., Dartois, N., Gaillat, J.: Longitudinal DRG-based survey of all-cause and pneumococcal pneumonia and meningitis for inpatients in France (2005–2010). Médecine et Maladies Infectieuses 45, 446–455 (2015)
Sato, R., Gomez Rey, G., Nelson, S., Pinsky, B.: Community-acquired pneumonia episode costs by age and risk in commercially insured US adults aged ≥50 years. Appl. Health Econ. Health Policy 11(3), 251–258 (2013)
Castiglia, Paolo: Recommendations for pneumococcal immunization outside routine childhood immunization programs in western Europe. Adv. Ther. 31(10), 1011–1044 (2014)
Stupka, J.E., Mortensen, E.M., Anzueto, A., Restrepo, M.I.: Community-acquired pneumonia in elderly patients. Aging Health 5(6), 763–774 (2009)
Bonafede, M.M., Suaya, J.A., Wilson, K.L., Mannino, D.M., Polsky, D.: Incidence and cost of CAP in a large working-age population. Am. J. Manag. Care. 18(7), 380–387 (2012)
Bordon, J., Wiemken, T., Peyrani, P., Paz, M.L., Gnoni, M., Cabral, P., Venero Mdel, C., Ramirez, J.: CAPO study group decrease in long-term survival for hospitalized patients with community-acquired pneumonia. Chest 138(2), 279–283 (2010)
Brito, V., Niederman, M.S.: Predicting mortality in the elderly with community-acquired pneumonia: should we design a new car or set a new ‘speed limit’? Thorax 65, 944–945 (2010)
Fine, M.J., Auble, T.E., Yealy, D.M., et al.: A prediction rule to identify low-risk patients with community-acquired pneumonia. N. Engl. J. Med. 33, 243–250 (1997)
AFFSAPS 2015. Antibiothérapie par voie générale en pratique courante dans les infections respiratoires basses. http://www.infectiologie.com/UserFiles/File/medias/_documents/consensus/2005-infVRB-recos-afssaps.pdf. Accessed 08 Dec 2016
http://www.invs.sante.fr/Dossiers-thematiques/Maladies-infectieuses/Maladies-a-prevention-vaccinale/Couverture-vaccinale/Donnees/. Accessed 08 Dec 2016
Charlson, M.E., Pompei, P., Ales, K.L., MacKenzie, C.R.: A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J. Chron. Dis. 40(5), 373–383 (1987)
Gaillat, J., Varon, E., Lanotte, P., Lepoutre, A., Pelloux, I., Epaulard, O., Bernard, L., Chavanet, P., Mootien, Y.: Surveillance épidémiologique clinico-microbiologique des infections invasives à pneumocoque de l’adulte (IIP) (SIIPA). Médecine et maladies infectieuses 46, 3–4 (2016)
Weycker, D., Farkouh, R.A., Strutton, D.R., Edelsberg, J., Shea, K.M., Pelton, S.I.: Rates and costs of invasive pneumococcal disease and pneumonia in persons with underlying medical conditions. BMC Health Ser. Res. 16, 182 (2016)
Ament, A., Baltussen, R., Duru, G., Rigaud-Bully, C., de Graeve, D., Ortqvist, A., Jönsson, B., Verhaegen, J., Gaillat, J., Christie, P., Salazar Cifre, A., Vivas, D., Loiseau, C., Fedson, D.S.: Cost-effectiveness of pneumococcal vaccination of older people: a study in 5 Western European countries. Clin. Infect. Dis. 31, 444–450 (2000)
Jiang, Y., Gervais, F., Gauthier, A., Baptiste, C., Martinon, P., Bresse, X.: A comparative public health and budget impact analysis of pneumococcal vaccines: the French case. Hum. Vaccin. Immunother. 11(9), 2188–2197 (2015). doi:10.1080/21645515.2015.1011957
Ostermann, H., Garau, J., Medina, J., Pascual, E., McBride, K., Blasi, F., on behalf of the REACH study group: Resource use by patients hospitalized with community-acquired pneumonia in Europe: analysis of the REACH study. BMC Pulm. Med. 14, 36 (2014)
Bonten, M.J.M., Huijts, S.M., Marieke Bolkenbaas, M., Webber, C., Patterson, S., et al.: Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. NJEM 372(12), 1114–1125 (2015)
Vissink, C.E., Huijts, S.M., de Wit, G.A., Bonten, M.J.M., Mangen, M.J.J.: Hospitalization costs for community acquired pneumonia in Dutch elderly: an observational study. BMC Infect. Dis. 16, 466 (2016)
Sicras-Mainar, A., Ibáñez-Nolla, J., Cifuentes, I., Guijarro, P., Navarro-Artieda, R., Aguilar, L.: Retrospective epidemiological study for the characterization of community-acquired pneumonia and pneumococcal pneumonia in adults in a well-defined area of Badalona (Barcelona, Spain). BMC Infect. Dis. 12, 283 (2012)
Klok, R.M., Lindkvist, R.M., Ekelund, M., Farkouh, R.A., Strutton, D.R.: Cost-effectiveness of a 10- versus 13-valent pneumococcal conjugate vaccine in Denmark and Sweden. Clin. Ther. 35(2), 119–134 (2013)
Bauer, T.T., Welte, T., Ernen, C., Schlosser, B.M., Thate-Waschke, I., de Zeeuw, J., Schultze-Werninghaus, G.: Cost analyses of community-acquired pneumonia from the hospital perspective. Chest 128(4), 2238–2246 (2005)
Boccalini, S., Bechini, A., Levi, M., Tiscione, E., Gasparini, R., Bonanni, P.: Cost-effectiveness of new adult pneumococcal vaccination strategies in Italy. Hum. Vaccines Immunother. 9(3), 699–706 (2013)
Acknowledgements
This project is the result of the generous and constructive contribution of all the researchers in the following hospital centers: Dr. Chantal Belleguic, Dr. Stéphane Jouneau, Hôpital Pontchaillou; Rennes, Dr. Daniel Benhamou, Hôpital Bois-Guillaume, CHU Rouen; Prof. François Bricaire, Dr. Loïc Epelboin, Hôpital de la Pitié-Salpêtrière Paris; Prof. Christian Chidiac, Dr. Joseph Koffi, Hôpital de la Croix-Rousse Lyon; Prof. Louis-Jean Couderc, Dr. Emilie Catherinot, Hôpital Foch Suresnes; Dr. Gilles Devouassoux, Hôpital de la Croix-Rousse Lyon; Dr. Jacques Gaillat, Muriel Picou-Leblanc (ARC), Gaëlle Clavère (ARC), Centre Hospitalier de la Région d’Annecy; Dr. Gilles Jebrak, Hôpital Bichat-Claude Bernard Paris; Prof. Henri Laurichesse, Dr. Hajnal-Gabriela Illes, Dr. Natacha Mrozek, CHU Gabriel Montpied Clermont Ferrand; Prof. Yves Pacheco, Dr. Nathalie Freymond, Centre Hospitalier Lyon-Sud; Dr. Patrick Petitpretz, Hôpital André Mignot Versailles; Dr. Bruno Philippe, Dr. Jean-François Boitiaux, Centre Hospitalier René Dubos, Pontoise; Dr. Sandrine Pontier, CHU de Toulouse-Hôpital Larrey; Dr. Olivier Raffy, Dr. Juliana Darasteanu, Hôpital Louis Pasteur, Chartres; Dr. Olivier Rogeaux, Dr. Emmanuel Forestier, Centre Hospitalier de Chambéry; Dr. Sergio Salmeron, Dr. Jean-lucJagot, Marie Josée Aroulanda (ACR), Groupe Hospitalier Paris Saint-Joseph; Prof. Pierre-Jean Souquet, Audrey Lucardi (ARC), Centre Hospitalier Lyon-Sud; Prof. Jean-Paul Stahl, CHU de Grenoble; Dr. Mathieu Priner, CHU de Poitiers; Prof. Dominique Salmon Ceron, Dr. Tan Boum Kim, Hôpital Cochin Paris; Prof. Jean-Paul Mira, Dr. Nathalie Marin, Hôpital Cochin, Paris; Dr. Anne Bergeron-Lafaurie, Hôpital Saint Louis, Paris; Prof. Louis Bernard, Karine Fèvre (ARC), CHRU de Tours-Hôpital Bretonneau; Prof. Pascal Chavanet, Dr. Marielle Buisson, Sandrine Treuvelot-Gohier (ARC), CHU de Dijon; Dr. Alassane Sougue, CH de Dreux; Dr. Claire Andrejak, CHU d’Amiens; Dr. Etienne Devin, CHI Eure Seine-Hôpital d’Evreux; Dr. Francine de Salvador-Guillouet, CHU de Nice; Prof. Olivier Sanchez, Amélie Marquette (ARC), Hôpital Européen Georges Pompidou, Paris; Prof. Jean-Damien Ricard, Dr. Jonathan Messika, Hôpital Louis Mourier, Colombes; Dr. Laurent Portel, CH de Bergerac; Dr. François Goupil, Anaig Le Cam (ARC), CH du Mans; Dr. Michel Farny, Céline Thomas (TEC), CH de Cahors; Dr. Véronique Rémy, CH de Cahors; Dr. Isabelle Honore, Hôpital Cochin, Paris; Dr. Thierry Prazuck, Barbara De Dieuleveult (ARC), CH d’Orléans; Dr. Stéphanie Dehette, Dr. Antoine Belle, Dr. Sandrine Loutski, Jean-Christophe Seghezzi (ARC), CH de Compiègne; Dr. Bernard Garo, CHU de Brest; Prof. Thierry May, Dr. Hajnal-Gabriela Illes, CHU de Nancy.
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Funding
This study received an unrestricted research grant from Pfizer France.
Conflict of interest
Authors J. Gaillat, C. Chidiac, P. Petitpretz and G. de Pouvourville received industry sponsor grants and advisor honoraria from Pfizer.
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Jonathan Messika and Jean-Damien Ricard are members of the GREPI (French Group for Research and Education in Respiratory Infectious Diseases).
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Saba, G., Andrade, L.F., Gaillat, J. et al. Costs associated with community acquired pneumonia in France. Eur J Health Econ 19, 533–544 (2018). https://doi.org/10.1007/s10198-017-0900-z
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DOI: https://doi.org/10.1007/s10198-017-0900-z