Guest J F, Morris A
CATALYST Healthcare Communications, Pinner, Middlesex, UK.
Eur Respir J. 1997 Jul;10(7):1530-4. doi: 10.1183/09031936.97.10071530.
The aim of this study was to estimate the direct annual healthcare costs to the UK National Health Service (NHS) of managing community-acquired pneumonia. Using a prevalence-based burden of illness approach, health service resource use and corresponding costs attributable to the management of community-acquired pneumonia during 1992/1993 in the UK were obtained from published sources and commercial databases, and supplemented by a telephone survey of general practitioners, finance directors, community nurses, receptionists and nurses in out-patient respiratory clinics, ambulance services, and consultant respiratory physicians. The study was appraised by a Peer Review Panel, representing a cross-section of experts from different locations. This study was a predefined subgroup analysis of a previous, larger study that estimated the annual cost to the NHS of treating all community-acquired lower respiratory tract infections. The analysis shows that there are 261,000 episodes of community-acquired pneumonia annually in the UK, costing 440.7 million pounds at 1992/1993 prices (32% of the annual cost for all community-acquired lower respiratory tract infections). Approximately 83,153 annual cases of community-acquired pneumonia are treated in hospital (32% of all episodes) and account for 96% of the annual cost. The average cost for managing pneumonia in the community is 100 pounds per episode, compared to 1,700-5,100 pounds when the patient is hospitalized, depending on the length of hospitalization. Hospitalization accounts for 87% of the total annual cost. In conclusion, community-acquired pneumonia in the UK incurs a direct healthcare cost of 440.7 million pounds annually at 1992/1993 prices. Developing and implementing strategies to prevent and minimize hospitalization will significantly reduce this annual cost and should be assessed in future studies.
本研究旨在估算英国国家医疗服务体系（NHS）管理社区获得性肺炎的年度直接医疗费用。采用基于患病率的疾病负担方法，从已发表的资料和商业数据库中获取了1992/1993年英国社区获得性肺炎管理所涉及的卫生服务资源使用情况及相应费用，并通过对全科医生、财务总监、社区护士、门诊接待员、门诊呼吸科护士、救护服务人员以及呼吸科顾问医生进行电话调查加以补充。该研究由一个同行评审小组进行评估，该小组代表了来自不同地区的专家群体。本研究是对先前一项更大规模研究的预先定义亚组分析，该研究估算了NHS治疗所有社区获得性下呼吸道感染的年度费用。分析表明，英国每年有26.1万例社区获得性肺炎病例，按1992/1993年价格计算，费用为4.407亿英镑（占所有社区获得性下呼吸道感染年度费用的32%）。每年约有83153例社区获得性肺炎病例在医院接受治疗（占所有病例的32%），占年度费用的96%。社区管理肺炎的平均费用为每例100英镑，而患者住院时的费用为1700 - 5100英镑，具体取决于住院时长。住院费用占年度总费用的87%。总之，按1992/1993年价格计算，英国社区获得性肺炎每年产生的直接医疗费用为4.407亿英镑。制定和实施预防及尽量减少住院的策略将显著降低这一年度费用，未来研究应对此进行评估。
