Assessing the burden of pneumonia using administrative data from Malaysia, Indonesia, and the Philippines

• The incidence of community-acquired pneumonia and hospital-acquired pneumonia among hospitalized patients in Malaysia, Indonesia, and the Philippines was studied.
• The case fatality rate, cost per admission, and length of stay were also calculated.
• Results varied between countries but were plausible based on the local context.
• These findings contribute to a better understanding of pneumonia in the Southeast Asia region.

SummaryObjectivesTo describe the incidence, mortality, cost, and length of stay (LOS) of hospitalized community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in three Southeast Asian countries: Malaysia, Indonesia, and the Philippines.MethodsUsing Casemix system data from contributing hospitals, patients with International Classification of Diseases 10th revision (ICD-10) codes identifying pneumonia were categorized into CAP or HAP using a logical algorithm. The incidence among hospitalized patients, case fatality rates (CFR), mean LOS, and cost of admission were calculated. The population incidence was calculated based on Malaysian data.ResultsFor every 100 000 discharges, CAP and HAP incidences were 14 245 and 5615 cases, respectively, in the Philippines, 4205 and 2187, respectively, in Malaysia, and 988 and 538, respectively, in Indonesia. The impact was greatest in the young and the elderly. The CFR varied from 1.4% to 4.2% for CAP and from 9.1% and 25.5% for HAP. The mean LOS was 6.1–8.6 days for CAP and 6.9–10.2 days for HAP. The cost of hospitalization was between USD 254 and USD 1208 for CAP and between USD 275 and USD 1482 for HAP.ConclusionsThe burden of CAP and HAP is high. Results varied between the three countries, likely due to differences in socio-economic conditions, health system differences, and ICD-coding practices.