Epidemiologic trends in the hospitalization of elderly Medicare patients for pneumonia, 1991-1998

Objectives. This study determined hospitalization rates of elderly Americans for pneumonia from 1991 through 1998. Methods. Epidemiologic data were described for 273 143 pneumonia hospitalizations. Results. Annual hospitalizations for aspiration pneumonia increased by 93.5%. Pneumonia hospitalization rates increased steeply with age, especially among men. Black men were at highest risk for aspiration, unspecified, Klebsiella, "other gram-negative," and staphylococcal pneumonia; White men had the highest Haemophilus and pneumococcal pneumonia rates. Among women, Blacks predominated in aspiration and Klebsiella pneumonia; Whites had the highest Haemophilus and bronchopneumonia rates. Conclusions. An epidemic of hospitalization for aspiration pneumonia smoldered over 8 years. Significant disparities existed in hospitalization risks by race, sex, and principal diagnosis.