COMMUNITY ACQUIRED PNEUMONIA;

ASSESSMENT OF COMPONENTS OF DIRECT COST OF TREATMENT OF HOSPITALIZED PATIENTS IN KARACHI.

Abstract

Background: The treatment cost of community acquired pneumonia in Pakistan
is a heavy economic burden for the society. Objectives: To assess the component of direct
cost (ward cost, medication cost, laboratory and diagnosis cost and the length of stay cost) of
treatment of community acquired pneumonia patients admitted in hospital ward. Study Design:
Prospective study. Period: 15 months. Setting: Three private hospitals among these hospitals
one of the hospital was a tertiary care university hospital situated in Karachi. Method: The study
enrolled 514 patients and the patients were included from three private hospitals. Spearman
correlation statistical tool was used to determine the correlation among variables Whitney U test
was used to determine the cost in different groups. Results: A total of 514 cases were examined
322 cases were male and 192 cases were females. The CAP cases were mostly prevalent
in patients with the age between 1-5 years (192), in male, low socioeconomic status and in
unmarried patients. The mean length of hospital stay was 5.31days found in patients admitted
in the hospitals due to CAP. In this study the median medication cost of CAP per episode of
treatment was Rs 2423($24.25), median laboratory diagnosis cost was found Rs 1310($13.11),
median length of stay in hospital cost was found Rs 5700($57.04) and the median total cost
of treatment was found Rs 9889($98.96). Conclusion: length of stay, laboratory diagnosis
and the medication cost were the main components of direct cost of treatment of hospitalized
cap patients. Age, comorbidity, PSI, laboratory diagnosis and length of stay was positively
correlated with the direct cost of treatment of CAP. Gender difference was not correlated with
the direct cost of treatment of CAP. The direct cost, drug cost, hospital stay cost increases as
the pneumonia severity index increases, but in case of laboratory diagnosis cost is initially less
in PSI I and increases in the PSI class II but remain same from PSI III to PSI V.