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Service, please: Hospital setting matters for pneumonia


Inpatients with pneumonia are just slightly more likely to receive chest x-rays than those in the ED, but there are considerable discrepancies between the two settings for other services, the National Center for Health Statistics (NCHS) reported.

Services received during pneumonia hospitalizations, 2014
Just over 65% of inpatients with a first-listed diagnosis of pneumonia and 63% of those treated in the ED received a chest x-ray in 2014, according to a National Hospital Care Survey demonstration project involving inpatient claims data from 94 hospitals (30,705 hospitalizations), of which 88 also provided ambulatory claims data (24,711 ED visits).

The percentages were not as close, however, for other diagnostic services. Inpatient stays were much more likely than ED encounters to involve bacteriology and microbiology testing (75.3% vs. 31.2%), CT scans (41.2% vs. 11.5%), and pulmonary function tests (33.7% vs. 9.8%), investigators from the NCHS said.

The age distribution of the two patient populations also were quite different, with those aged 65 years and older making up the largest share (46%) of pneumonia inpatients and the 15-and-under group representing the largest proportion (47%) of ED visits. For the inpatient setting, the smallest age group was those aged 15-44 years (10%), and for the ED it was those aged 65 years and older (14%), they reported.

The National Hospital Care Survey “is not yet nationally representative,” the NCHS investigators wrote – the overall sample for 2014 consisted of 581 hospitals – but “the number of encounters and the inclusion of [personally identifiable information] allow an example of analysis that was not previously possible.”

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