Abstract

The aim of this study was to compare volume and structure of direct medical costs of CAP at patients with comorbidities and without them. Pharmacoeconomical study of 438 CAP in-patients (male - 213 (48.6%), mean age – 56.1±17,9) was conducted. Comorbidities were present in 359 (82.0%) patients and polymorbidities (two and more diseases) were registered in 216 (49.3%). The most frequent diseases were pathology of cardiovascular, respiratory, digestive system, diabetes mellitus and obesity. It had been established mean CAP costs was 2444,69±2328,63 UAH. Costs of moderate severe CAP was cheaper - 2046,25±777,86 UAH then severe CAP - 6521,04±6107,44 UAH (p<0,001). Polymorbidity causes statistically significant increase CAP costs in 1.4 times. Antibiotic therapy (1151,82±1835,82 UAH) and accommodation (973,35±1042,46 UAH) was the most expensive without dependence of comorbidities. Costs of diagnostic procedures was significantly higher in CAP patients with polymorbidity - 213,76±200,58 UAH then without it - 141,97±33,16 UAH, or in CAP-patients with one chronic disease - 151,31±56,15 UAH (p<0,001). Costs of symptomatic and pathogenical treatment was bigger in CAP patients without comorbidities - 116,64±87,27 UAH., against - 85,44±69,75 UAH (p<0,001). Significantly higher costs of CAP were in patients with congestive heart failure, diabetes mellitus, exacerbations of COPD and asthma. Presence two and more comorbidities increases 1,4 times direct medical costs of CAP, particulary in patients with congestive heart failure, diabetes mellitus, exacerbation of chronic obstructive pulmonary disease and asthma. The biggest part of direct medical costs of CAP in-patients is antibacterial therapy.