The incremental cost of infections associated with multidrug‐resistant organisms in the inpatient hospital setting—A national estimate

• Published in: Health services research 2019-08, Vol.54 (4), p.782-792
• Main Authors: Johnston, Kenton J., Thorpe, Kenneth E., Jacob, Jesse T., Murphy, David J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Analysis; Anti-Bacterial Agents - therapeutic use; Bacteria; Bacterial infection; Bacterial infections; Bacterial Infections - economics; Bacterial Infections - epidemiology; Care and treatment; Cross Infection - economics; Cross Infection - epidemiology; Data collection; Drug resistance in microorganisms; Drug Resistance, Multiple, Bacterial; Economic aspects; Economics, Hospital; Extraction; Female; Health care; Health care costs; Health Care Utilization and Cost; hospital care; Hospital Costs - statistics & numerical data; Hospitalization; Hospitals - statistics & numerical data; Humans; Identification methods; Infection; Infections; Inpatient care; Length of stay; Length of Stay - economics; Male; Medical care, Cost of; Medical economics; Medical research; Methicillin; Microbial drug resistance; Middle Aged; MRSA; Multidrug resistance; Multidrug resistant organisms; Patients; Regression analysis; Regression models; Residence Characteristics; Retrospective Studies; Socioenvironmental Therapy; Staphylococcal infections; Staphylococcus aureus infections
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.13135

Objective To estimate the cost of infections associated with multidrug‐resistant organisms (MDROs) during inpatient hospitalization in the United States. Data Sources/Study Setting 2014 National Inpatient Sample. Study Design Multivariable regression models assessed the incremental effect of MDROs on the cost of hospitalization and hospital length of stay among patients with bacterial infections. Data Collection/Extraction Methods We retrospectively identified 6 385 258 inpatient stays for patients with bacterial infection. Principal Findings The national incidence rate of inpatient stays with bacterial infection is 20.1 percent. At least 10.8 percent of such stays—and as many as 16.9 percent if we account for undercoded infections—show evidence of one or more MDROs. MRSA, C. difficile, infection with another MDRO, and the presence of more than one MDRO are associated with $1718 (95% CI, $1609‐$1826), $4617 (95% CI, $4407‐$4827), $2302 (95% CI, $2044‐$2560), and $3570 (95% CI, $3019‐$4122) in additional costs per stay, respectively. The national cost of infections associated with MDROs is at least $2.39 billion (95% CI, $2.25‐$2.52 billion) and as high as $3.38 billion (95% CI, $3.13‐$3.62 billion) if we account for undercoded infections. Conclusions Infections associated with MDROs result in a substantial cost burden to the US health care system.