Journal Article

Short- and Long-Term Attributable Costs of Clostridium difficile-Associated Disease in Nonsurgical Inpatients

Erik R. Dubberke, Kimberly A. Reske, Margaret A. Olsen, L. Clifford McDonald and Victoria J. Fraser

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 46, issue 4, pages 497-504
Published in print February 2008 | ISSN: 1058-4838
Published online February 2008 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/526530
Short- and Long-Term Attributable Costs of Clostridium difficile-Associated Disease in Nonsurgical Inpatients

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Background. The incidence of Clostridium difficile– associated disease (CDAD) is increasing. There are few data on the short-term and long-term attributable costs of CDAD. The objective of this study was to determine the acute and 180-day attributable inpatient costs of CDAD.

Methods. We performed a retrospective cohort study of all patients without operating room costs who were admitted for ⩾ 48 h to Barnes-Jewish Hospital, a tertiary care hospital in St. Louis, Missouri, 1 January 2003– 31 December 2003 (n=24,691). Attributable costs of CDAD were determined by multivariable linear regression and propensity-score matched-pairs analyses (n=684) for the hospitalization in which CDAD occurred and per patient over a 180-day period, including the initial hospitalization.

Results. CDAD was associated with $2454 (95% confidence interval, $2380– $2950; increase in cost, 41%) attributable costs per CDAD episode by linear regression and with $3240 attributable costs (P< .001; increase in cost, 33%) by propensity-score matched-pairs analysis. CDAD was associated with $5042 (95% confidence interval, $3797– $6481; increase in cost, 53%) attributable inpatient costs over 180 days by linear regression and with $7179 attributable costs for inpatient care (P< .001; 48% increase in costs) by propensity-score matched-pairs analysis.

Conclusions. CDAD was associated with a significant increase in costs for inpatient care and increased costs at 180 days after the initial hospitalization when the CDAD episode occurred.

Journal Article.  3864 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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