The cost of pneumonia after acute stroke
IL Katzan, NV Dawson, CL Thomas, ME Votruba… - Neurology, 2007 - AAN Enterprises
IL Katzan, NV Dawson, CL Thomas, ME Votruba, RD Cebul
Neurology, 2007•AAN EnterprisesObjective: To determine the incremental costs of pneumonia occurring during hospitalization
for stroke. Methods: We reviewed hospital records of all Medicare patients admitted for
ischemic or hemorrhagic stroke to 29 hospitals in a large metropolitan area, 1991 through
1997, excluding those who died or had do not resuscitate orders written within 3 days of
admission. Hospital costs of patients with stroke were determined using Medicare Provider
Analysis and Review data after adjustment for baseline factors affecting cost and propensity …
for stroke. Methods: We reviewed hospital records of all Medicare patients admitted for
ischemic or hemorrhagic stroke to 29 hospitals in a large metropolitan area, 1991 through
1997, excluding those who died or had do not resuscitate orders written within 3 days of
admission. Hospital costs of patients with stroke were determined using Medicare Provider
Analysis and Review data after adjustment for baseline factors affecting cost and propensity …
Objective: To determine the incremental costs of pneumonia occurring during hospitalization for stroke.
Methods: We reviewed hospital records of all Medicare patients admitted for ischemic or hemorrhagic stroke to 29 hospitals in a large metropolitan area, 1991 through 1997, excluding those who died or had do not resuscitate orders written within 3 days of admission. Hospital costs of patients with stroke were determined using Medicare Provider Analysis and Review data after adjustment for baseline factors affecting cost and propensity for pneumonia. Secondary analyses examined the risk-adjusted relationship of pneumonia to discharge disposition.
Results: Pneumonia occurred in 5.6% (635/11,286) of patients with stroke, and was more common among patients admitted from nursing homes and those with greater severity of illness (p < 0.001). Mean adjusted costs of hospitalization for patients with stroke with pneumonia were $21,043 (95% CI $19,698 to 22,387) and were $6,206 (95% CI $6,150 to 6,262) for patients without pneumonia, resulting in an incremental cost of $14,836 (95% CI $14,436 to 15,236). Patients with pneumonia were over 70% more likely to be discharged with requirements for extended care (adjusted OR 1.73, 95% CI 1.32 to 2.26).
Conclusion: Extrapolated to the over 500,000 similar patients hospitalized for stroke in the United States, the annual cost of pneumonia as a complication after acute stroke is approximately $459 million.
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