OBJECTIVES: To identify incidence and direct medical cost of patients diagnosed with all-cause pneumonia and acute otitis media through EMR database and health information database (HID) in Minhang district, Shanghai. METHODS: Cases were definite by ICD-10 code and identified for a two-year period, from Jan 1^st of 2011 to Dec 31th of 2012 from EMR database. Relevant medical cost was collected from HID, ancillary cost data – such as costs of medical procedures, medications, and facility utilization was estimated through survey. These data were combined used unique patients identification number. Patients were classified into age groups and incidence and medical costs data were reported based on the age groups. RESULTS: The highest incidence of inpatient all-cause pneumonia was 795 episodes per 100,000 person-year in children under 2 years, it decreases as population ages but reverse the trend with patients age 50 and above. The second high incidence appeared in senior people aged 65 and above (249 per 100,000 person year). There was similar trend for outpatient all- cause pneumonia and Acute Otitis Media. The cost analysis indicated that the medical direct cost per case increases and population ages. The highest median cost (95% range) for hospitalization all-cause pneumonia was RMB 7,851.6 (1,903.7-47,607.4) Yuan for age 65 and older, and the lowest cost per case appeared in children under 2 years. Similar trend was also observed for the outpatient all-cause pneumonia costs and AOM costs. CONCLUSIONS: Outpatient all-cause pneumonia is a major public burden in current Chinese treatment pattern of pneumococcal relevant diseases, especially in children under 5 and senior people age 65 and above. In adults and senior people, the medical direct cost of all-cause pneumonia reaches 7,851 RMB per episode which accounts for 9.51% of 2011 Shanghai per person GDP and 22.32% of 2011China per person GDP.