Keuhkokuumeesta aiheutunut sairaalahoito Suomessa 1972-1993

Abstract A study is made of the volume of hospital treatment provided for cases of pneumonia in Finland from 1972 to 1993, employing as a source the National Hospital Discharge Register. The results are used to predict changes in the utilization of hospital resources in this respect up to the year 2020. A total of 452 474 treatment periods and 5 935 615 hospitalization days attributable to pneumonia were recorded for the total population over the given period, of which just under 20% applied to children aged under 15 years, over 30% to persons of working age, 15-64 years, and over 50% to elderly persons aged 65 years and over. The mean duration of hospitalization was reduced from 18.4 days to 14.3 days for males and from 19.6 days to 17.5 days for females over the period in question. The number of treatment periods for pneumonia in children per year relative to population decreased by 28.3%, the greatest reduction being in the group under one year of age, 5.7% for boys and 5.5% for girls. The mean duration of treatment decreased from 9.6 days to 4.1 days for boys and 9.7 days to 4.3 days for girls. The numbers of treatment periods and hospitalization days were consistently greater for men than for women in the working-age population, the difference between the sexes being most pronounced in the age group 15 - 24 years, where the number of treatment periods for men was 7.2 times that for women. Likewise, the number of treatment periods for men began to increase with age from 40 years onwards and that for women from 50 years onwards. The mean treatment time for patients of working-age decreased over the period studied, from 10.5 days to 8.2 days for men and from 9.9 days to 8.2 days for women. The duration of treatment similarly increased with advancing age. The absolute numbers of treatment periods increased by 139% among the elderly population, even when standardized for age, whereas the number of hospitalization days diminished. The clearest increase in treatment periods of all was recorded for men aged over 84 years, 3.16%. The mean duration of treatment increased with age in both sexes, being significantly longer for women than for men in each age group. The forecast for changes in the utilization of hospital services for the treatment of pneumonia up to the year 2020 was examined by methods based on both an age structure model and a time series model. Both predicted an increase of over 50% in the total number of treatment periods for the population as a whole, being of the order of 70% for men and 30% for women. The predicted increase in the age group over 64 years was in excess of 90% with both models. The use of hospital services for the treatment of childhood pneumonia decreased significantly over the period examined here, while the majority of the treatment periods recorded for the working-age population concerned young men or persons aged over 40 years. The most significant increase was seen in treatment periods for persons aged over 64 years, and this figure is also predicted to increase in the future, on account of the frequent use made of hospital services by the elderly in general. Preparations should be made for dealing with this increase in demand by improving treatment methods, developing the treatment system and undertaking preventive measures