Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 51, Issue 6 M276-M282, Copyright © 1996 by The Gerontological Society of America
Hospitalization for pneumonia among older adults
CM Callahan and FD Wolinsky
Department of Medicine, Indiana University School of Medicine, USA. [email protected]
BACKGROUND: Hospitalizations and mortality due to pneumonia increase
steadily with age. The purpose of this study is to describe the frequency,
costs, and risk factors for hospitalization for pneumonia among older
adults with particular attention to the effect of functional disability.
METHODS: The Longitudinal Study of Aging (LSOA) is the follow-up to the
Supplement on Aging, which was appended to the 1984 National Health
Interview Survey. Participants included a nationally representative sample
of 7,527 community-dwelling adults aged 70 and older in 1984 who were
followed prospectively for 8 years. The LSOA data are linked to the
National Death Index and to yearly abstracts from the Medicare Automated
Data Retrieval System (1984- 1991). RESULTS: From 1984 to 1991, 617
subjects (8.2%) had at least one hospitalization for pneumonia, 4,333
(57.5%) had at least one hospitalization for any reason, and 2,867 (38.1%)
of the LSOA subjects died. The yearly frequency of hospitalization for
pneumonia increased over time from 0.6% in 1984 to 2.4% in 1991. The median
length of stay was 8 days, and the median hospital charge was $5,100. Over
8 years, median discounted charges for a pneumonia hospitalization
increased 75% while length of stay remained relatively constant. Patients
hospitalized for pneumonia had greater comorbidity, total hospital resource
use, and mortality, but over 80% survived their first hospitalization for
pneumonia. Hospitalization for pneumonia was associated with age, male
gender, malnutrition, history of hip fracture, prior hospitalizations, and
lower body limitations. CONCLUSIONS: Hospitalization for pneumonia was
frequent and accounted for 6% of the Medicare expenditures over 8 years
among this cohort of older adults. Hospitalization for pneumonia occurred
most often among subjects with prior evidence of failing health, but most
subjects survived the first hospitalization for pneumonia. Even controlling
for comorbidity, prior hospitalizations, and functional impairment,
hospitalization for pneumonia was independently associated with age.
