Health Care Resources Associated with Clinical Pneumonia, Bacteremia or Meningitis in Colombian Adults: A Retrospective Database Study

OBJECTIVES: To describe the healthcare resources related to the clinical management of pneumonia, bacteremia or meningitis of adult patients in one health maintenance organization (HMO) in Colombia, Sura.

METHODS: This is a retrospective, observational-cohort-study in adult patients diagnosed with pneumonia, bacteremia, or meningitis, based on the International Classification of Diseases 10^th codes (without a documented etiology), who received medical care from the HMO services between 2015 and 2022. A micro-costing method was used based on data on hospital stay (general-ward [GW] and intensive care unit [ICU]) and outpatient care. Cost estimates derived from the Colombian “sufficiency study technical note” and Colombian drug prices and sales database (SISMED). Costs were adjusted to 2023 US dollars.

RESULTS: 112,205 patients were observed; however, 81,238 had available information on any of the analyzed costs. Most cases presented pneumonia (n=76,708), 81.9% outpatient (n= 62,853) and 18.1% inpatient (n=13,855), followed by bacteremia (n=7,006), and meningitis (n=412). The median cost for outpatient pneumonia was 7.4 USD (interquartile range [IQR] 19.1) while inpatient was 1665.6 USD (IQR 1665.6), for bacteremia 2,220.8 USD (IQR 2,734.0), and for meningitis 2,378.7 USD (IQR 2,819.6). The main cost driver was the length of stay (LoS) in GW or ICU. For hospitalized cases, those with pneumonia had a median GW LoS of 6 days (IQR 5), for bacteremia 7 (IQR 9) and meningitis 8 (IQR 9). Considering that the daily GW cost was 277.6 USD and ICU 2,523.3 USD, the median ICU LoS for pneumonia were 13 days (IQR 14), for bacteremia 14 (IQR 18), and meningitis 19.5 (IQR 15.8).

CONCLUSIONS: Among the diseases studied, pneumonia represents the greatest burden, considering that it has the largest number of patients. However, the pneumonia median per patient costs tended to be lower than those with meningitis and bacteremia. The main drivers of healthcare costs are GW or ICU admissions.