Preventive medication/vaccinations

Preventive measures for CAP included influenza and pneumococcal vaccinations, consistent with Infectious Diseases Society of America and the American Thoracic Society Consensus Guidelines on the Management of Community-Acquired Pneumonia [16]. Preventive medications for MI and stroke comprised of antihypertensives, statins, aspirin, anticoagulants, and antiplatelet medications. OF preventive measures included bisphosphonates, selective estrogen receptor modulators, and injectable therapies (denosumab and teriparatide). All medications were identified by Medi-Span Generic Product Identifier (GPI) codes in the pharmacy claims. Injectable medications and vaccinations were also identified by Current Procedural Terminology codes and Healthcare Common Procedure Coding System codes in the medical claims. Codes for preventive medications are available in Appendix 2 Table 5.

Total summed costs for hospitalizations, readmissions, and total combined costs were described as well as per event costs. Admission, re-admission, and mortality rates were standardized to events per 100,000 life-years to allow direct comparison between conditions within the cohort. Data management and analysis were conducted using SAS Enterprise Guide 5.1 (SAS Institute, Cary, NC). This manuscript was drafted in accordance with STROBE reporting guidelines (http://www.strobe-statement.org/) for observational studies.