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Health Informatics Unit
The University of Adelaide
SA 5005 Australia
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Significance of Community Acquired Pneumonia (CAP)

Scott Clark

Health Informatics, Adelaide University

Community-acquired pneumonia CAP is a major cause of morbidity, mortality and health cost world-wide [ 1 2 ]. In Australia CAP effects 2 in every 1000 adults per year, accounts for 2% of overnight hospital admissions and has a mortality rate of approximately 10% [3] . Recent research indicates that the median cost of treating CAP is in the vicinity of $US 6000 dollars per patient [4] . There is also a high cost to the patient and the health care system in terms of complications of pneumonia, their associated morbidity, investigation and treatment. Meta-analysis by Fine et al. [5] identified 23 types of complication arising from pneumonia including high rates of pleural effusion (10.6%), respiratory failure (7.8%), empyema (5.2%), congestive heart failure (8.6%), shock (7.7%), hepatic abnormalities (12.3%), and renal failure (10.4%).

The effect of pneumonia on the community extends beyond time in hospital. A number of studies have shown that symptoms persist up to 90 days beyond hospital stay resulting in personal and social costs of delayed return to normal activities [ 6 7 ].

References

1. Bartlett JG, Breiman RF, Mandell LA, File TM, Jr. Community-acquired pneumonia in adults: guidelines for management. The Infectious Diseases Society of America. Clin Infect Dis 1998;26(4):811-38.

2. Guest JF, Morris A. Community-acquired pneumonia: the annual cost to the National Health Service in the UK. Eur Respir J 1997;10(7):1530-4.

3. Tsirgiotis E, Ruffin R. Community acquired pneumonia. A perspective for general practice. Aust Fam Physician 2000;29(7):639-45.

4. Fine MJ, Pratt HM, Obrosky DS, Lave JR, McIntosh LJ, Singer DE, et al. Relation between length of hospital stay and costs of care for patients with community-acquired pneumonia [In Process Citation]. Am J Med 2000;109(5):378-85.

5. Fine MJ, Smith MA, Carson CA, Mutha SS, Sankey SS, Weissfeld LA, et al. Prognosis and outcomes of patients with community-acquired pneumonia. A meta-analysis [see comments]. Jama 1996;275(2):134-41.

6. Metlay JP, Fine MJ, Schulz R, Marrie TJ, Coley CM, Kapoor WN, et al. Measuring symptomatic and functional recovery in patients with community-acquired pneumonia. J Gen Intern Med 1997;12(7):423-30.

7. Metlay JP, Atlas SJ, Borowsky LH, Singer DE. Time course of symptom resolution in patients with community-acquired pneumonia. Respir Med 1998;92(9):1137-42.