Direct hospitalization costs of children with Mycoplasma pneumoniae pneumonia from 2013 to 2025 in China: a longitudinal retrospective single-center study

Background: pneumonia (MPP) is one of the most common type of community-acquired pneumonia. Due to the diversity in treatment measures and macrolide-resistant, the medical burden of hospitalized children remains uncertain. Methods: This study conducted a retrospective analysis of pediatric patients diagnosed with MPP and hospitalized at Shanghai Children's Medical Center over a 13-year period, from January 2013 to June 2025. The duration of hospital stay, total hospitalization costs, and drug costs per hospitalization were analyzed by year, corticosteroid administration, and presence of macrolide-resistant genes. Results: A total of 4,684 hospitalized children with MPP were included. The median age of the cohort was 6.50 years (quartile: 4.20-8.30 years), and the median duration of hospital stay was 5.00 days (quartile: 4.00-7.00 days). The median cost per hospitalization was $1,250.52 (quartile: $1,016.06-$1,612.27), while the median drug cost per hospitalization was $124.02 (quartile: $75.00-$199.31). Significant differences were observed in the duration of hospital stay, total costs, and drug costs per hospitalization between the age groups < 3, 3-6, 6-10, and ≥10 years. Additionally, significant differences were found between patients who received corticosteroids and those who did not, in terms of hospital stay duration, total costs, and drug costs per hospitalization. Conclusions: The medical burden associated with MPP in children under 3 years of age warrants attention and should be a focus of medical reimbursement policy considerations.