Criteria designed to assist in pneumonia patients’ care
Researchers have developed a method to help clinicians assess the risks faced by pneumonia patients -- the clinical criteria could determine the need for hospitalization and help reduce the more than $4 billion spent annually for inpatient care for patients with pneumonia, according to the Agency for Health Care Policy and Research (AHCPR).
About 600,000, or 15 percent, of the 4 million Americans who develop pneumonia each year are hospitalized. Because of a lack of accurate criteria to assess a patient’s risk and a tendency to overestimate the risk of death, many low-risk patients who could be safely treated without hospitalization are admitted for inpatient care.
The projections are based on a prospective study of 2,300 patients in Pittsburgh, Boston, and Halifax, Nova Scotia. They were treated for pneumonia at home or in the hospital; results suggest that 26 to 31 percent of those hospitalized could have been treated as outpatients if new criteria had been used. “This is one of 15 studies on common medical conditions that are costly and have significant variations in patterns of treatment,” said the study’s author, Michael J. Fine, MD, MSc, associate professor of medicine at the University of Pittsburgh School of Medicine. “The wide variations suggest that physicians don’t have consistent criteria. We wanted to develop a model to assist physicians in identifying the risks.”
The model identifies five risk classes, ranging from an extremely low risk of dying or medical complications to an extremely high risk.
The model is described in the Jan. 23 issue of the New England Journal of Medicine. The findings are summarized in two fact sheets available from AHCPR: What’s New for Clinicians: Pneumonia, New Prediction Model Proves Promising (Publication number 97-R031) and What’s New for Consumers: Pneumonia, More Patients May Be Treated At Home, (97-R030). The fact sheets are available from AHCPR, (800) 358-9295, or AHCPR Instant FAX, (301) 594-2800.
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