OBJECTIVES

: To describe the direct medical costs of hospitalizations due to community-acquired pneumonia (CAP) in adults treated at the Costa Rican Social Security System (CCSS) between 2005 and 2014.

METHODS

: Cost of Illness study that described all hospital admissions of adults (≥20 years) with a diagnosis of CAP according to the CCSS epidemiological database for the period analyzed. The International Classification of Diseases was used for classification CAP. The codes used were: J10.0 to J18.9. Cases diagnosed as nosocomial were excluded. The direct medical costs were based on average hospitalization daily cost per year obtained from CCSS and were adjusted for inflation and exchange rate of each year (USD). Descriptive statistics were used to analyze results.

RESULTS

: A total of 33,262 cases of CAP were identified from 2005 thru 2014. The average hospital stay remained relatively constant during this period: 12.0 days in 2005 and 12.5 days in 2014. The average number of admissions per year in age groups from 20-34, 35-64, and ≥65 years, were 720, 610 and 1996 respectively. The average cost of daily hospitalization $585 in 2005 to $821 in 2014, with a compound annual growth rate (CAGR) of 3.4%. Total direct costs in 2005 were $20,802,434 increasing to $39,356,534 in 2014, with a CAGR of 6.6%, it was due to an increase in hospital admissions per NAC per year, particularly in the elderly, an increase of 37% in that period. For this age group cost increment was from $12,575,086 in 2005 to $24,930,044 in 2014.

CONCLUSIONS

: Direct medical cost for CAP in the CCSS hospital network increased 89% in the period analyzed. This was partly due to cost increment, but also explained by increasing total hospital admissions mainly in the elderly. It is necessary to consider preventive strategies such as vaccination against bacterial and viral pneumonia to reduce costs.