OBJECTIVES: To evaluate 1-year unadjusted economic outcomes among patients hospitalized with CAP in the US.

METHODS: This retrospective cohort study included adult patients hospitalized with CAP 1/2012-12/2016 identified via administrative coding in IQVIA’s Hospital Charge Data Master linked to Real-World Data Adjudicated Claims. Patients who were continuously enrolled ≥180 days prior to and ≥360 days following the admission date, received empiric antimicrobial treatment as combination (EC) or monotherapy (EM) and had a chest x-ray on admission date or 1 day after were included. We examined healthcare resource utilization and costs for the index hospitalization and over a 1-year follow up period.

RESULTS: Among 1,624 patients hospitalized with CAP (mean age 50.3 years; 52.8% female; 49.3% commercially-insured), the majority (78.2%) were treated with EC (most common: β-lactam plus macrolide, 30.0%). Mean length of stay (LOS) and mean cost of the index hospitalization were 5.7 days, and $17,736, respectively. The 30-day and 180-day readmission rates were 8.8% and 20.1%, respectively. Patients on EC had significantly higher average LOS (6.0 vs. 4.8 days, p<0.0001) and hospital cost ($18,830 vs. $13,813, p=0.0008) associated with the index hospitalization compared to patients on EM. Over the 1-year follow-up, patients had an average of 1.7 hospitalizations and spent an average of 11.9 total days in hospital. They also had an average of 19.0 physician office visits. Average annual all-cause cost per patient was $61,928, of which $20,954 (33.8%) was related to CAP. The major cost component, inpatient care ($34,685, 56%), was significantly higher among patients receiving EC than EM ($37,106 vs. $25,999, p=0.0399).

CONCLUSIONS: Patients hospitalized for CAP incurred significant costs during admission and in the 1-year follow-up, one-third of which were specific to CAP. Annual costs were driven substantially by inpatient costs, which were significantly higher among patients receiving EC than EM.