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Pneumonia and the Necessity of Hospitalization

Pneumonia is a common type of pulmonary disease that involves inflammation and infection of the lungs, triggering an overproduction of mucus at the level of the respiratory tract. The intensity and the duration of the symptoms generated by pneumonia differ from a person to another, according to factors such as age, overall health and the immune system’s capability of fighting against infections. While people with strong immune systems are less likely to acquire pneumonia and develop complications, people with compromised immune systems or increased susceptibility to respiratory disorders are exposed to a high risk of developing complicated forms of pneumonia. Due to this fact, pneumonia has a high incidence in elderly people, which also commonly develop further complications.

In present, most people diagnosed with pneumonia require hospitalization. In the absence of proper medical care and frequent monitoring, some patients with pneumonia may experience a rapid aggravation of the disease, and for this reason doctors recommend hospitalization to all pneumonia sufferers. However, patients with milder, uncomplicated forms of pneumonia can be spared of hospitalization, by receiving medical treatment at home. Considering the fact that once developed, pneumonia is little contagious, patients with milder forms of the disease rarely spread it to other people. Thus, certain categories of patients with pneumonia can receive pneumonia treatments in the comfort of their homes. In fact, patients with mild types of pneumonia such as “walking pneumonia” don’t even require bed confinement, being able to carry on with their daily activities on the entire duration of the treatment.

On the premises of hospital overcrowding and very high hospitalization costs, doctors have lately focused on limiting the overall number of unnecessary hospitalizations. In future, hospitalization may even be avoided for elderly people in nursing homes when they develop pneumonia. Recent studies have revealed the fact that certain nursing home residents can be spared of hospitalization, by receiving pneumonia treatments in nursing homes instead. Elderly people in nursing homes already benefit from medical surveillance and assistance, rarely requiring hospital medical care. Judging by this fact, nursing home residents diagnosed with mild, uncomplicated forms of pneumonia that have a stable overall condition may not require hospitalization at all.

By reducing the number of unnecessary hospitalizations among nursing home residents with pneumonia, both patients and doctors may benefit from the process. Furthermore, judging from a financial point of view, avoidance of unnecessary hospitalization can save up to 1.500 dollars per patient.

In order to determine the necessity of hospitalization among nursing home residents with pneumonia, a group of Canadian researchers has recently conducted a study that involved the collaboration of 20 nursing homes. Half of these institutions were asked to follow their usual medical care procedures, while the others were asked to follow the instructions imposed by the researchers. Thus, when they were confronted with cases of pneumonia among residents, each group of nursing homes followed a different approach: the usual care group transferred patients with pneumonia to the hospital, while the referential group followed the imposed guidelines before deciding upon hospitalization.

The established guidelines required nursing home residents with stable conditions to receive the treatment of pneumonia inside the nursing home. Residents that didn’t meet the established criteria (presented with complications or had unstable conditions) were transferred to the hospital. The referential group involved the participation of 327 nursing home residents with pneumonia, while the usual care group included 353 residents with pneumonia. During the study, only 10 percent, respectively 22 percent of the residents in the two groups were eventually hospitalized. By the end of the study, the researchers concluded that residents in both groups responded similarly to the treatment of pneumonia, regardless of medical regimen. Thus, the study has confirmed the fact that hospitalization can be avoided for nursing home residents diagnosed with mild, uncomplicated forms of pneumonia.

Generalized appliance of the Canadian researchers’ guidelines regarding the necessity of hospitalization among nursing home residents with pneumonia can considerably reduce medical care costs. Researchers inform that by reducing the number of unnecessary hospitalization among residents with pneumonia, the costs savings would be around 70 million US dollars for Canada and up to 800 million US dollars for the United States each year.

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