Scientific Publications Database

Article Title: Hospital-acquired Clostridium difficile infection: an institutional costing analysis
Authors: Choi, K. B.; Suh, K. N.; Muldoon, K. A.; Roth, V. R.; Forster, A. J.
Journal: JOURNAL OF HOSPITAL INFECTION Volume 102 Issue 2
Date of Publication:2019
Abstract:
Background: Healthcare-acquired Clostridium difficile infection (HA-CDI) is a common infection and a financial burden on the healthcare system.Aim: To estimate the hospital-based financial costs of HA-CDI by comparing time-fixed statistical models that attribute cost to the entire hospital stay to time-varying statistical models that adjust for the time between admission, diagnosis of HA-CDI, and discharge and that only attribute HA-CDI costs post diagnosis.Methods: A retrospective cohort study was conducted (April 2008 to March 2011) using clinical and administrative costing data of inpatients (>= 15 years) who were admitted to The Ottawa Hospital with stays >72 h. Two time-fixed analyses, ordinary least square regression and generalized linear regression, were contrasted with two time-dependent approaches using Kaplan-Meier survival curve.Findings: A total of 49,888 admissions were included and 366 (0.73%) patients developed HA-CDI. Estimated total costs (Canadian dollars) from time-fixed models were as high as $74,928 per patient compared to $28,089 using a time-varying model, and these were 1.47-fold higher compared to a patient without HA-CDI (incremental cost $8,997 per patient). The overall annual institutional cost at The Ottawa Hospital associated with HA-CDI was as high as $10.07 million using time-fixed models and $1.62 million using time-varying models.Conclusion: When calculating costs associated with HA-CDI, accounting for the time between admission, diagnosis, and discharge can substantially reduce the estimated institutional costs associated with HA-CDI. (C) 2019 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.