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

• Published in: Clinical infectious diseases 2008-02, Vol.46 (4), p.497-504
• Main Authors: Dubberke, Erik R., Reske, Kimberly A., Olsen, Margaret A., McDonald, L. Clifford, Fraser, Victoria J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Articles and Commentaries; Bacteria; Clostridium; Clostridium difficile - isolation & purification; Cohort Studies; Cost analysis; Cost estimates; Cost of Illness; Enterocolitis, Pseudomembranous - economics; Enterocolitis, Pseudomembranous - microbiology; Epidemiology; Female; Health Care Costs; Health care expenditures; Hospital admissions; Hospital costs; Hospitalization; Hospitals; Humans; Infectious diseases; Linear regression; Male; Middle Aged; Missouri; Patients; Regression analysis; Retrospective Studies; Studies
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/526530

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.