Financial burden of hospital-acquired Clostridium difficile infection

• Published in: The Journal of hospital infection 1996-09, Vol.34 (1), p.23-30
• Main Authors: Wilcox, M.H., Cunniffe, J.G., Trundle, C., Redpath, C.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - economics; Anti-Bacterial Agents - therapeutic use; antibiotic costs; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Case-Control Studies; Clostridium difficile; Costs and Cost Analysis; Cross Infection - drug therapy; Cross Infection - economics; Enterocolitis, Pseudomembranous - drug therapy; Enterocolitis, Pseudomembranous - economics; Female; Human bacterial diseases; Humans; Infectious diseases; Length of Stay - economics; Male; Medical sciences; Prospective Studies; United Kingdom
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/S0195-6701(96)90122-X

Clostridium difficile infection has become endemic in many hospitals and yet few data on the associated costs of such cases are available. We prospectively followed 50 consecutive cases of C. difficile infection and 92 control patients, who were admitted to the same geriatric wards within 72 h of the cases. Cases and controls had similar age, sex and major diagnosis distributions. Cases stayed significantly longer (mean 21·3 days, median 20·5 days; P < 0·001) in hospital than controls, including an average 14 days in a side room. Diarrhoea developed in cases on average 10·8 days after admission, which, when compared with a mean duration of stay for controls of 25·2 days, implies that C. difficile infection caused an increased duration of stay, as opposed to infection occurring because of longer residence. There was a significantly higher death rate in cases compared with controls ( P < 0·01). Antibiotic treatment of C. difficile infection cost an average of £47 per case. The average number of laboratory investigations per day was similar for cases and controls, but the increased length of stay meant an extra cost for tests of approximately £210 per case. Assuming hotel costs of £150 (£200) per day stay (in a side room), 94% of the additional costs associated with C. difficile infection were due to increased duration of stay (£3850). The total identifiable increased cost of C. difficile infection was, therefore, in excess of £4000 per case. Such high costs can be used to justify expenditure on personnel and/or other control measures to reduce the incidence of this hospital-acquired infection.