BAINE WB, YU W, SUMME JP, PARK YJ; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1999 Sep 26-29; 39: 699 (abstract no. 2231).
Agency for Health Care Policy and Res., Rockville, MD.
BACKGROUND: "Pneumonitis due to inhalation of food or vomitus" (aspiration pneumonia) is second only to "pneumonia, organism unspecified," as the principal diagnosis in Medicare patients aged 65 years and older hospitalized for pulmonary infection.METHODS: Medicare inpatient claims data for 1991-1996 were analyzed.RESULTS: Crude yearly hospital discharges of aged Medicare patients with this principal diagnosis increased 76% over 1991-1996. Secular increases in age-specific discharge rates were most marked in the very old. Mean costs and Medicare hospital reimbursements were lowest for white women (hospital length of stay 10.4 days, intensive care stay 0.8 days, reimbursement $8,246) and highest for black men (hospital 14.2 days, intensive care 1.1 days, reimbursement $10,333). Case-fatality rates in hospital ranged from 23% in white women to 26% in black men. An additional 22% of patients discharged alive to home or self care were dead within 90 days of admission, and 90-day survival was even lower in patients sent to home health service care or to another facility. Among aged Medicare patients with a principal diagnosis of aspiration pneumonia, the commonest other discharge diagnoses were volume depletion, congestive heart failure, and urinary tract infection. Common other discharge diagnoses most strongly associated with a principal diagnosis of aspiration pneumonia as compared to pneumococcal pneumonia were dysphagia, gastrostomy status, and staphylococcal pneumonia. Common other discharge diagnoses increasing most steeply from 1991 through 1996 were congestive heart failure; essential hypertension, unspecified; and volume depletion.CONCLUSION: This is a lethal and costly epidemic. Further investigation must concentrate upon possible causal factors.
Publication Types:
Keywords:
- African Americans
- Aged
- Disease Outbreaks
- European Continental Ancestry Group
- Female
- Heart Failure
- Hospitalization
- Hospitals
- Humans
- Male
- Medicare
- Patient Discharge
- Pneumonia
- Pneumonia, Aspiration
- economics
Other ID:
UI: 102246394
From Meeting Abstracts