Health Care Costs and Financing

Pneumococcal disease continues to lead to substantial health care use and costs

Despite the widespread use of vaccination for adults and children, Streptococcus pneumoniae (pneumococcus) remains a substantial cause of illness and death, concludes a new study. The bacteria causes localized disease such as acute otitis media (AOM, ear infections) and sinusitis, as well as serious infections such as pneumonia and meningitis. The study, based on 2004 data, offers a broad portrait of the impact of pneumococcus on health care use and costs. In that year, pneumococcus caused an estimated 4 million disease episodes. Over 3.5 million disease episodes were treated solely in outpatient settings, with AOM and sinusitis responsible for 85 percent of outpatient cases (1.5 million cases each). Of the 445,000 pneumococcal-related hospitalizations, more than 90 percent were for pneumonia.

Health care use attributable to pneumococcal disease in its various forms included an estimated 5 million outpatient visits, 4.1 million outpatient antibiotic prescriptions, 774,000 emergency department visits, 445,000 hospitalizations, and 24,000 nursing home stays. Overall, pneumococcal hospitalizations were responsible for 2.3 million hospital days.

Direct medical costs attributable to pneumococcal disease were estimated to be $3.5 billion. Work loss costs added $914 million and productivity costs due to death and disability added another $3.1 billion. Conditions treated in the hospital were responsible for 76 percent ($2.6 billion) of direct medical costs and 82 percent ($6.3 billion) of total costs. Adults accounted for 83 percent ($3 billion) of direct health care costs and 84 percent ($6.5 billion) of total costs when work loss and productivity costs were included. This study was supported in part by the Agency for Healthcare Research and Quality (HS14563).

See "Healthcare utilization and cost of pneumococcal disease in the United States," by Susan S. Huang, M.D., Kristen M. Johnson, G. Thomas Ray, M.B.A., and others in Vaccine 29, pp. 3398-3412, 2011.

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