TY - JOUR
T1 - Cost burden of Clostridioides difficile infection to the health service
T2 - A retrospective cohort study in Scotland
AU - Robertson, Chris
AU - Pan, Jiafeng
AU - Kavanagh, Kim
AU - Ford, Ian
AU - McCowan, Colin
AU - Bennie, Marion
AU - Marwick, Charis
AU - Leanord, Alistair
N1 - Funding Information:
We thank Andrew Walker, who supported the economic analysis for this study. We would also like to acknowledge the support of the eDRIS Team (Public Health Scotland) for their involvement in obtaining approvals, provisioning and linking data and the use of the secure analytical platform within the National Safe Haven. This study uses data provided by patients and collected by the NHS as part of their care and support. This study was initiated and supported by Astellas Pharma Europe, Ltd . Medical writing support was provided by Rhian Harper Owen, PhD, for Cello Health MedErgy (Europe), funded by Astellas Pharma Inc . These data were presented in part as oral and poster presentations at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID), 22nd –25th April 2017, Vienna, Austria.
Publisher Copyright:
© 2020 The Authors
PY - 2020/11
Y1 - 2020/11
N2 - Background: Clostridioides difficile infection (CDI) is associated with high healthcare demands and related costs.Aim: To evaluate the healthcare and economic burden of CDI in hospitalized patients with community- (HOCA-CDI) or hospital-associated CDI (HOHA-CDI) in the National Health Service in Scotland.Methods: A retrospective cohort study was conducted, examining data between August 2010 and July 2013 from four patient-level Scottish datasets, linked to death data. Data examined included prior antimicrobial prescriptions in the community, hospitalizations, length of stay and mortality. Each CDI case was matched to three hospital-based controls on the basis of age, gender, hospital and date of admission. Descriptive economic evaluations were based on bed-day costs for different types of wards.Findings: Overall, 3304 CDI cases were included in the study. CDI was associated with additional median lengths of stay of 7.2 days for HOCA-CDI and 12.0 days for HOHA-CDI compared with their respective, matched controls. The 30-day mortality rate was 6.8% for HOCA-CDI and 12.4% for HOHA-CDI. Overall, recurrence within 90 days of the first CDI episode occurred in 373/2740 (13.6%) survivors. The median additional expenditure for each initial CDI case compared with matched controls was £1713. In the 6 months after the index hospitalization, the cost associated with a CDI case was £5126 higher than for controls.Conclusion: Using routinely collected national data, we demonstrated the substantial burden of CDI on healthcare services, including lengthy hospital stays and readmissions, which increased the costs of managing patients with CDI compared with matched controls.
AB - Background: Clostridioides difficile infection (CDI) is associated with high healthcare demands and related costs.Aim: To evaluate the healthcare and economic burden of CDI in hospitalized patients with community- (HOCA-CDI) or hospital-associated CDI (HOHA-CDI) in the National Health Service in Scotland.Methods: A retrospective cohort study was conducted, examining data between August 2010 and July 2013 from four patient-level Scottish datasets, linked to death data. Data examined included prior antimicrobial prescriptions in the community, hospitalizations, length of stay and mortality. Each CDI case was matched to three hospital-based controls on the basis of age, gender, hospital and date of admission. Descriptive economic evaluations were based on bed-day costs for different types of wards.Findings: Overall, 3304 CDI cases were included in the study. CDI was associated with additional median lengths of stay of 7.2 days for HOCA-CDI and 12.0 days for HOHA-CDI compared with their respective, matched controls. The 30-day mortality rate was 6.8% for HOCA-CDI and 12.4% for HOHA-CDI. Overall, recurrence within 90 days of the first CDI episode occurred in 373/2740 (13.6%) survivors. The median additional expenditure for each initial CDI case compared with matched controls was £1713. In the 6 months after the index hospitalization, the cost associated with a CDI case was £5126 higher than for controls.Conclusion: Using routinely collected national data, we demonstrated the substantial burden of CDI on healthcare services, including lengthy hospital stays and readmissions, which increased the costs of managing patients with CDI compared with matched controls.
KW - Clostridioides difficile infection
KW - Community infection
KW - Cost burden
KW - Hospital infection
KW - Retrospective cohort
UR - http://www.scopus.com/inward/record.url?scp=85091613300&partnerID=8YFLogxK
U2 - 10.1016/j.jhin.2020.07.019
DO - 10.1016/j.jhin.2020.07.019
M3 - Article
C2 - 32717202
SN - 0195-6701
VL - 106
SP - 554
EP - 561
JO - Journal of Hospital Infection
JF - Journal of Hospital Infection
IS - 3
ER -
