Bacterial pneumonia hospitalization and pneumonia inpatient mortality in Texas, 1999-2007
Abstract
Bacterial pneumonia has a disproportionate impact on the elderly. It is considered as an ambulatory care-sensitive condition by the Agency for Healthcare and Research (AHRQ), for which good outpatient care can potentially prevent the need for hospitalization or for which early intervention can prevent complications or more severe disease that lead to death. This project evaluated the trends in bacterial Pneumonia hospitalization and pneumonia inpatient mortality rates of older Texans during 1999-2007, and identifies the associated individual and contextual factors. \r\nThe data were from the Texas Hospital Discharge data during 1999-2007, linked with US Census data and Area Resource File. Observed and adjusted rates were calculated for Texas counties. Poisson regression and logistic regression models were used to evaluate the individual and contextual factors associated with bacterial pneumonia hospitalization and pneumonia inpatient mortality rates, respectively.\r\nThe study found that both bacterial pneumonia hospitalizations and pneumonia inpatient mortality rates were decreasing during 1999-2007. Population aged 75 years or above and Hispanics had the highest hospitalization and inpatient mortality rates. Increasing percent of Hispanics at the county-level was associated with a significant decrease of hospitalization rate and inpatient mortality rate. More number of non-Federal MDs per capita was associated with lower hospitalization rate and inpatient mortality rate. More hospital beds was associated with lower pneumonia inpatient mortality rates.\r\nThis study suggests interventions at county-level have great potential to improve the quality of pneumonia preventive and inpatient care for older population. \r\n