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Attributable Inpatient Costs of Recurrent Clostridium difficile Infections

Published online by Cambridge University Press:  10 May 2016

Erik R. Dubberke ,
Eric Schaefer ,
Kimberly A. Reske ,
Marya Zilberberg ,
Christopher S. Hollenbeak  and
Margaret A. Olsen
Erik R. Dubberke*
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri
Eric Schaefer
Affiliation:
Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
Kimberly A. Reske
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri
Marya Zilberberg
Affiliation:
EviMed Research Group, Goshen, Massachusetts; and University of Massachusetts, Amherst, Massachusetts
Christopher S. Hollenbeak
Affiliation:
Department of Surgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
Margaret A. Olsen
Affiliation:
Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri
*
Division of Infectious Diseases, Washington University School of Medicine, Box 8051, 660 South Euclid, St. Louis, MO 63110 (edubberk@dom.wustl.edu).
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Abstract

Objective.

To determine the attributable inpatient costs of recurrent Clostridium difficile infections (CDIs)

Design.

Retrospective cohort study.

Setting.

Academic, urban, tertiary care hospital.

Patients.

A total of 3,958 patients aged 18 years or more who developed an initial CDI episode from 2003 through 2009.

Methods.

Data were collected electronically from hospital administrative databases and were supplemented with chart review. Patients with an index CDI episode during the study period were followed up for 180 days from the end of their index hospitalization or the end of their index CDI antibiotic treatment (whichever occurred later). Total hospital costs during the outcome period for patients with recurrent versus a single episode of CDI were analyzed using zero-inflated lognormal models.

Results.

There were 421 persons with recurrent CDI (recurrence rate, 10.6%). Recurrent CDI case patients were significantly more likely than persons without recurrence to have any hospital costs during the outcome period (P < .001). The estimated attributable cost of recurrent CDI was $11,631 (95% confidence interval, $8,937–$14,588).

Conclusions.

The attributable costs of recurrent CDI are considerable. Patients with recurrent CDI are significantly more likely to have inpatient hospital costs than patients who do not develop recurrences. Better strategies to predict and prevent CDI recurrences are needed.

Infect Control Hosp Epidemiol 2014;35(11):1400–1407

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 11 , November 2014 , pp. 1400 - 1407
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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