OBJECTIVES:

Among military personnel, bacterial pneumonia (BP) is the most common respiratory infection for hospital admissions, associated with a significant economic burden in the United States. We examined the economic burden and health care utilization (HRU) of BP in the US Department of Defense (DoD) population.

METHODS:

Patients diagnosed with BP were identified (International Classification of Diseases [ICD], 9^th Revision, Clinical Modification diagnosis code 482.9; ICD-10: J15.9) using DoD data from 01OCT2011-30SEP2016. The first diagnosis date was designated as the index date. A comparison cohort was created for non-BP patients with the same age, gender, race, and index year—as well as similar baseline Charlson Comorbidity Index scores—as the disease cohort. The index date was chosen randomly for the comparison cohort to minimize selection bias. Patients in both cohorts were required to have continuous medical and pharmacy benefits 1 year pre- and post-index date. Study outcomes, including HRU and costs, were compared between the disease and comparison cohorts based on the matched sample.

RESULTS:

Eligible patients (N=6,342) with and without BP were identified. After 1:1 propensity score matching, 4,655 patients were identified in each cohort with well-balanced baseline characteristics. Patients with BP were more likely to report a greater mean number of inpatient (0.5 vs 0.1 visit, p<0.001), emergency room (ER; 1.3 vs 0.5 visits, p<0.001), ambulatory (23.2 vs 12.3 visits, p<0.001), and pharmacy (14.0 vs 9.0 visits; p<0.001) visits. Higher all-cause health care costs were observed among BP patients, including mean inpatient ($7,736 vs $1,582; p<0.001), ER ($816 vs $310; p<0.001), ambulatory ($6,994 vs $3,403; p<0.001), pharmacy ($2,146 vs $881; p<0.001), and total costs ($17,692 vs $6,176; p<0.001).

CONCLUSIONS:

During a 12-month period, DoD patients diagnosed with BP reported higher HRU and costs than their matched controls.