It can be difficult to quantify the exact economic burden of Clostridium difficile infections on hospitals and the health system as a whole, but a recent study has put a dollar amount on the cost of C. difficile-associated diarrhea that is not only big but also likely to be underestimated, according to HealthLeaders Media.
Published in the November 2015 issue of the American Journal of Infection Control, the study found that CDAD increases hospital costs by 40% per case and puts those infected at high risk for longer hospital stays and readmissions.
Researchers conducted a retrospective analysis of inpatient hospital data, examining 171,586 eligible discharges from between January 2009 and December 2011 at approximately 500 U.S. hospitals in the Premier Healthcare database.
The 40% increase in costs per case added up to an average of $7,285 in additional costs. Costs were higher for certain high-risk subgroups of patients. In addition, compared with patients without C. difficile infection, those infected had an estimated 77% greater chance of being readmitted within 30 days; a 55% longer hospital stay of nearly five days; and a 13% greater risk of mortality.
According to lead author Glenn Magee, MBA, other studies into the cost of C. difficile infections have been limited in both geography and demographics — and sometimes limited to single hospitals — causing some hospital executives to question whether their own hospitals would experience the same cost burden. But the hospitals in the Premier Healthcare database are geographically diverse and provide a representative sampling of both teaching and nonteaching hospitals, Magee said.
According to the authors, the study’s estimates were conservative for the health system as a whole, mainly because they didn’t factor in the cost of readmissions, but “only considered hospital costs and not physician or treatment costs beyond the index hospitalization.”
“The assumption is that a lot of those readmissions are related to treatment for C. diff. The real cost is actually greater than $7,300,” Magee said. “The total impact on health systems as a whole is much greater than that.”
The study also looked at CDAD-attributable costs for certain high-risk subgroups of patients and found that they were only slightly higher than the costs for the general population. These groups included patients with renal impairment ($8,942), with immunocompromised status ($8,692), or with concomitant antibiotic exposure ($8,545).
According to Magee, hospital leaders and other stakeholders within an organization should work with other nearby facilities, such as skilled-nursing facilities, to monitor and be proactive about admissions and discharges between and among institutions to ensure optimal care.
Source: HealthLeaders Media; January 18, 2016.