Hospitalization stay and costs attributable to Clostridium difficile infection: a critical review

Area of Science:

• Healthcare Economics
• Infectious Disease Management
• Hospital Administration

Background:

• Third-party payers fund most hospital costs for Clostridium difficile infection (CDI) admissions.
• Hospitals may not recoup all costs for CDI cases that arise as complications during hospitalization.
• Accurate cost attribution for CDI is essential for financial planning and prevention investment.

Purpose of the Study:

• To critically review and categorize hospital costs and length of stay (LOS) attributable to Clostridium difficile infection (CDI).
• To investigate the economic burden associated with CDI in hospitalized patients.
• To provide data for optimizing CDI prevention incentives.

Main Methods:

• A comprehensive literature review was conducted to identify studies reporting costs and LOS for hospitalized patients with CDI.
• Statistical methods were employed to isolate costs and LOS solely attributable to CDI.
• Twenty-four relevant studies were selected for analysis.

Main Results:

• Attributable costs varied: $6,774–$10,212 for CDI requiring admission, $2,992–$29,000 for hospital-acquired CDI.
• Attributable LOS ranged from 5–13.6 days for CDI requiring admission and 2.7–21.3 days for hospital-acquired CDI.
• Uncategorized CDI costs ranged from $2,454–$12,850 with LOS of 2.8–17.9 days.

Conclusions:

• Categorizing CDI-attributable costs enables budget holders to better anticipate expenses per case.
• This economic perspective can inform the design of effective incentives for CDI prevention.
• Optimizing global CDI prevention requires a clear understanding of associated healthcare costs.