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Updated: May 25, 2026
A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
Michigan Clostridium difficile hospital discharges: frequency, mortality, and charges, 2002-2008
Kerrie E VerLee1, Jennie L Finks, Melinda J Wilkins
1Council of State and Territorial Epidemiologists, Atlanta, GA, USA. kerrie.verlee@spectrumhealth.org
Objective:
Clostridium difficile (C. difficile) causes an intestinal bacterial infection of increasing importance in Michigan residents and health-care facilities. The specific burden and health-care costs of C. difficile infection (CDI) were previously unknown. We evaluated the frequency, mortality, and health-care charges of CDI from Michigan hospital discharge data.
Methods:
The Michigan Department of Community Health purchased discharge data from all Michigan acute care hospitals from the Michigan Health and Hospital Association. We extracted all hospital discharges from 2002 through 2008 containing the International Classification of Diseases, Ninth Revision code for intestinal infection due to C. difficile. Discharges were stratified by principle diagnosis and comorbidity level. Total hospitalization charges were standardized to the 2008 U.S. dollar.
Results:
From 2002 through 2008, 68,686 hospital discharges with CDI occurred. The annual rate increased from 463.1 to 1096.5 CDI discharges per 100,000 discharges. CDI discharge rates were substantially higher among the elderly, females, and black people. Of all CDI discharges, 5,924 (8.6%) patients died. The mean total health-care charge for the time period was $67,149, and the annual mean increased 35% from 2002 to 2008. Hospital charges varied significantly by race/ethnicity and age. People with Medicaid insurance accrued the highest charges.
Conclusion:
Across Michigan, the CDI burden is growing substantially and affecting vulnerable populations. Surveillance utilizing hospital discharge data can illuminate trends and inform intervention targets. To reduce disease and health-care charges, increased prevention and infection-control efforts should be directed toward high-risk populations, such as the elderly.
Insights
Clostridium difficile infection (CDI) in Michigan is rising, with significant increases in hospitalizations and costs. Vulnerable groups like the elderly are disproportionately affected, necessitating targeted prevention efforts.
Area of Science:
- Infectious Diseases
- Public Health
- Health Economics
Background:
- Clostridium difficile infection (CDI) is a growing concern in Michigan, impacting residents and healthcare facilities.
- Previous data on the specific burden and healthcare costs of CDI in Michigan were lacking.
Purpose of the Study:
- To evaluate the frequency, mortality, and healthcare charges associated with CDI in Michigan using hospital discharge data.
- To identify trends and high-risk populations for CDI in Michigan.
Main Methods:
- Utilized Michigan hospital discharge data from 2002-2008, sourced from the Michigan Health and Hospital Association.
- Extracted discharges coded for intestinal infection due to Clostridium difficile (ICD-9 code).
- Stratified discharges by primary diagnosis and comorbidity, standardizing charges to 2008 U.S. dollars.
Main Results:
- Observed 68,686 CDI hospital discharges between 2002-2008, with annual rates increasing from 463.1 to 1096.5 per 100,000 discharges.
- CDI rates were higher in the elderly, females, and Black individuals. 8.6% of patients with CDI died.
- Mean total healthcare charges were $67,149, increasing 35% from 2002-2008. Medicaid patients incurred the highest charges.
Conclusions:
- The burden of CDI in Michigan is substantially increasing, disproportionately affecting vulnerable populations.
- Hospital discharge data surveillance effectively identifies CDI trends and potential intervention targets.
- Enhanced prevention and infection control targeting high-risk groups, such as the elderly, are crucial to reduce CDI incidence and healthcare costs.
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