Economic burden of primary compared with recurrent Clostridium difficile infection in hospitalized patients; a prospective cohort study

Shah, D.N. et al. Journal of Hospital Infection. Published online: 20 April 2016

Background: Few studies have investigated the additional healthcare costs of recurrent C. difficile infection (CDI). The study objective was to quantify the additional length of stay and treatment costs of recurrent CDI episodes among hospitalized patients with CDI.

Methodology: This was a prospective, observational cohort study of hospitalized adult patients with primary CDI followed for three months to assess for recurrent CDI episodes. Total and CDI-attributable hospital length of stay (LOS) and hospitalization costs were compared among patients who did or did not experience at least one recurrent CDI episode.

Results: Five hundred and forty hospitalized patients aged 62±17 years (42% males) with primary CDI were enrolled, of whom 95 patients (18%) experienced 101 recurrent CDI episodes. CDI-attributable median (interquartile range) LOS and costs increased from 7 (4–13) days and $13,168 (7,525–24,456) in patients with primary CDI only vs. 15 (8–25) days and $28,218 (15,050–47,030) for patients with recurrent CDI (p<0.0001, each). Total hospital median LOS and costs increased from 11 (6–22) days and $20,693 (11,287–41,386) in patients with primary CDI only vs. 24 (11 – 48) days and $45,148 (20,693–82,772) in patients with recurrent CDI (p<0.0001, each). The median cost of pharmacologic treatment while hospitalized was $60 ($23–$200) in patients with primary CDI only (n=445) and $140 ($30–$260) in patients with recurrent CDI (p=0.0013).

Conclusion: This study demonstrated that patients with CDI experience a significant healthcare economic burden attributed to CDI. Economic costs and healthcare burden increased significantly in patients with recurrent CDI.

Read the abstract here

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