Increasing Rate of Pneumonia Hospitalizations among Older American Indian and Alaska Native Adults

Objective. To examine rates and trends of pneumonia hospitalization among older American Indian and Alaska Native (AI/AN) adults. Methods. Pneumonia hospitalizations for older AI/AN adults ≥65 years of age living in the Alaska and Southwest Indian Health Service (IHS) regions during 1988 through 2002 from the IHS hospital discharge data were analyzed. Results. The average annual hospitalization rate for first-listed pneumonia for older AI/AN adults in both the Alaska and the Southwest regions has increased (15.3 and 23.0 in 1988-1990 to 25.9 and 28.8 in 2000-2002 per 1,000 population, respectively), with the greatest increase seen among older AI/AN adults in the Alaska region. For both regions, the hospitalization rate increased with increasing age. The proportion of pneumonia hospitalizations with the co-morbid conditions of chronic heart disease, chronic lung disease and diabetes mellitus in the Alaska and the Southwest regions increased from 48.8% and 30.8% in 1988-1990 to 65.4% and 40.7% in 2000-2002, respectively. Conclusions. The rate of pneumonia hospitalizations among older AI/AN adults in the Alaska and the Southwest regions has increased substantially; the 2000-2002 rate was similar to or slightly higher than those reported for the general older US population. This rate increase and the increasing prevalence of chronic co-morbid conditions indicate a need for prevention efforts and health interventions among older AI/AN adults.