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Hospital-Treated Pneumonia Part 1: Diagnosis

Hospital-Treated Pneumonia Part 1: Diagnosis

In 2014, US healthcare spending exceeded $3.0 trillion with nearly 1/3 spent on hospitalizations. Informed by real-world data from an Electronic Health Record (EHR) database of clinical and administrative records spanning 272 million encounters for 60 million patients in 600+ hospitals across the US, Boston Strategic Partners (BSP) estimates 30% of all hospital discharges involve treatment of infectious organisms. Pneumonia is responsible for an estimated 12% of all hospital stays. At an average cost of $15,500 per occurrence, we estimate that hospitalizations for severe infections account for around $212 billion in annual spending or 7% of total healthcare expenditure. In this report, we conduct an in-depth analysis of pneumonia patient characteristics, costs, and laboratory testing.

Gram-negative bacteria are the likely causative agents of most pneumonia infections. From 2010-2015, drug resistant organisms caused a surprising 20% of bacterial pneumonia infections.

Hospital-Treated Pneumonia Part 1: Diagnosis is part one of a two-part series on hospital-treated sepsis. This report provides quantitative, objective data focused on the diagnosis of pneumonia captured by hospitals contributing to Cerner Health Facts. This data provides real-world patient encounters and reflects real physician diagnostic decisions and encounter characteristics (e.g. admissions and lab testing) in key areas, such as antibiotic resistant pathogens.

Focused on pneumonia requiring hospitalization, detailed analysis of over 680K hospital discharges from 2009 to 2015 (including projections through 2019)
Epidemiology of infection in the US, including demographic information, growth, overall patient encounter attributes, and most common causative agents
An overview of patients with pneumonia in the US, including region, gender, and age breakdown, payer type, infection type, associated patient comorbidities, and antibiotic usage
Analysis of Length of Stay (LOS), total costs, and admission data and how they correlate with the following:

Age of patient
APACHE II score
Care setting

Examination of frequently ordered lab tests and cultures with data on turnaround time (TAT) and results
Discussion of the increasing concern regarding antibiotic-resistant organisms

Growth
Costs
Outcomes
LOS"


1 Patient Flow
2 Executive Summary
3 Incidence and Impact of Disease
3.1 Incidence
3.2 Length of Stay
3.3 Total Cost
4 Patient Demographics
4.1 Age
4.2 Insurance type
4.3 Gender
4.4 Region
4.5 Mortality
4.6 Comorbid Conditions
5 Patient Segmentation by Diagnostic Testing
5.1 Causative Etiologic Agent
6 Length of Stay and Cost by Patient Segment
6.1 Age at Admission
6.2 APACHE II Score
6.3 First Care Setting
7 Patient Flow through the Hospital
7.1 Admission Site
7.2 Lab Testing
7.3 Lab TAT
7.4 Results
7.5 Etiology
8 Drug Resistant Pneumonia
8.1 Current Trends
8.2 Costs
8.3 Comorbidity
8.4 LOS
8.5 Mortality
9 Database Overview
10 Methodology

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