Length of hospital stay and cost of Staphylococcus and Streptococcus infections among hospitalized patients

• Published in: Clinical therapeutics 2002-05, Vol.24 (5), p.818-834
• Main Authors: Zhao, Sean Z., Dodge, William E., Spalding, William, Barr, Charles E., Li, Jim Z.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Analysis. Health state; Biological and medical sciences; Child; Comorbidity; Diagnosis; Diagnosis-Related Groups - economics; Diagnostic systems; Epidemiology; Female; General aspects; gram-positive infection; Hospitalization; Hospitalization - economics; Humans; Infections; Insurance, Hospitalization - economics; length of stay; Length of Stay - economics; Male; Medical sciences; Middle Aged; Morbidity; Patients; Payments; Public health. Hygiene; Public health. Hygiene-occupational medicine; Staphylococcal Infections - economics; Staphylococcus; Streptococcal Infections - economics; Streptococcus; Streptococcus infections; Surgery; total payments
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/S0149-2918(02)85155-4

Background:Staphylococcus (Staph) and Streptococcus (Strep) infections are important causes of morbidity and mortality worldwide. The economic burden of these infections is also significant, especially among hospitalized patients. Objective: The aim of this study was to estimate length of hospital stay (LOS) and total payments for hospital admissions for patients with Staph or Strep infection as a first (primary) or second or higher (comorbid) diagnosis. Methods: From the 1994–1997 MarketScan inpatient database, admissions with Staph (n = 2042) or Strep (n = 1401) infection (905 as primary and 2538 as comorbid diagnosis) and 89,899 control admissions without a diagnosis of gram-positive infection were identified. Crude and category-specific mean LOS and anti-log mean total payments were compared between admissions with Staph or Strep infection and admissions without a diagnosis of any gram-positive infection within major diagnostic categories and principal surgical procedures (SPs). Results: For admissions with Staph or Strep infection as first (primary) diagnosis (n = 905), the mean LOS was 4.68 days (95% CI, 4.44–4.93) and 4.78 days (95% CI, 4.35–5.26), respectively. The mean total payments were $6445 (95% CI, $6045–$6870) and $6821 (95% CI, $6149–$7566), respectively. In contrast, the average LOS and total payment for the control group were 2.99 days (95% CI, 2.98–3.01) and $6325 (95% CI, $6284–$6365). For admissions with infection as the comorbid diagnosis (n = 2538), mean LOS and total payment were 4 days longer and $6000 higher for Staph infections and 1.2 days longer and $1200 higher for Strep infections than the control group. Within each SP, LOS and total payments were substantially higher for patients with Staph and Strep infections. Conclusions: The results of this study indicate that infections with the pathogens Staph and Strep substantially increase LOS and total payments among hospitalized patients.