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May 10, 2006

Hospitalization Trends for Pneumonia Among Older Persons—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295(18):2137-2138. doi:10.1001/jama.295.18.2138-a

In Reply: Mr Zarogiannis and Dr Gourgoulianis suggest that differences in health care costs (approximated by duration of hospitalization) between the 3 elderly age groups might assist with targeting intervention programs. Duration of hospitalization for pneumonia did not vary significantly among the 3 age groups during 2000-2002 (Table). By contrast, the number of days spent in the hospital for first-listed pneumonia hospitalizations decreased from about 10 days during 1988-1990 to about 6 days during 2000-2002. Thus, while there is evidence of shorter hospitalizations in 2000-2002 vs 1988-1990, perhaps due to changes in medical practice, we do not see any indication in these data that differences in hospitalization length of stay among elderly US residents might warrant targeting of a specific age group for a particular intervention. Other factors should be considered, such as the effectiveness of treatment, the duration of effectiveness, and the effects of treatment on other age groups. Intervention strategies that reduce comorbid conditions, or vaccines against respiratory pathogens like respiratory syncytial virus, might have beneficial effects in younger persons, as well as among older adults.