Trends in Incidence and Economic Burden of Pneumonia in the United States from 2016-2021

OBJECTIVES: Despite available prevention measures, pneumonia remains one of the leading causes of hospitalization in the US, continuing to put a substantial economic burden on the US healthcare system. The purpose of this study was to examine trends in US incidence and economic burden of pneumonia care from 2016 to 2021.

METHODS: We assessed the Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey data, which collects data from members of sample households from communities across the US. These data can be used to produce nationally representative estimates of medical conditions, use of medical care services, charges, and payments, etc. We examined total cases, expenditures, and mean expenditure per person with care for pneumonia and compared its trends to influenza and COVID-19.

RESULTS: Over 100 million persons were examined between 2016 and 2021. Total cases of pneumonia and influenza decreased by 33% and 77%, respectively, from 2016 to 2021, while cases of COVID-19 emerged in 2020 and increased 46% in 2021. In 2021, there were 2.8 cases per 1,000 persons of pneumonia, 1.7 cases per 1,000 persons of influenza, and 20.9 cases per 1,000 persons of COVID-19. Total expenditure for pneumonia remained stable from 2016 to 2021 ($18 billion annually). In 2020, total expenditure for COVID-19 was $33.2 billion (CI $22.7 – $43.8 billion), surpassing that of pneumonia and influenza combined ($22.2 billion). However, the mean cost of pneumonia was 2 times higher than COVID-19 ($5,596 vs $2,678).

CONCLUSIONS: While total cases of pneumonia and influenza decreased from 2016 to 2021 amidst the pandemic, the mean cost of care increased. In 2021, the total cost for pneumonia care was $18.9 billion in addition to the $49.4 billion from COVID-19. Further research is needed to explore the drivers underlying the economic burden for pneumonia.