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The economic and service impact of invasive candidiasis in the UK

Abstract number: P1805

McEwan P., Morgan C., Irwin D., Asukai Y., Gasper S.

Background: Invasive candidiasis (IC) is a serious nosocomial infection likely to impact length of stay (LOS) and medical resource use in hospital. We examined the consequences of acquiring IC on healthcare resources to estimate their potential burden on the UK healthcare system.

Methods: We utilised data from the UK Clinical Hospital Knowledge System (CHKS), comprising national hospital inpatient activity and the Secondary Linked Inpatient to Mortality Dataset (SLIM) comprising the resident population of Cardiff and the Vale of Glamorgan (population of 424,000 – 2001 estimate). Patients with a diagnosis of invasive candidiasis as defined by selected ICD-10 codes (B37.1, B37.5, B37.6, B37.7, B37.8, B37.9) during 1995–2005 in SLIM and during 2005–2006 in CHKS were identified from inpatient admissions. A matched-pair analysis was performed by selecting control patients without IC matched on age, gender, primary diagnosis and procedure. LOS, mean admission costs and mortality were compared to determine the excess burden of IC.

Results: The majority of admissions had a primary diagnosis other than IC. From SLIM 275 IC patients were identified and 241 (96%) of these with a secondary diagnosis of IC were matched. Patients with a diagnosis of IC had increased medical resource use: longer mean LOS (13.3 days vs. 8 days), increased mean admission cost (£1,879 vs. £1,616) and increased hospital mortality (11% vs. 5%). From CHKS 6,105 (95.1%) patients with secondary diagnosis of IC were matched to patients without IC. Again, patients with a diagnosis of IC had increased mean LOS (16.6 vs. 5.6 days), higher mean admission costs (£1,739 vs. £1,531) and higher in-hospital mortality (11.3% vs. 5.0%). Patients with a diagnosis of IC who were in the ICU had longer mean overall hospital LOS (40.3 v 20.8 days) and increased mean LOS in ICU compared to non-IC patients (16.7 days v. 7.5 days).

Conclusions: Patients with IC have overall longer LOS in hospital and in the ICU compared to patients without IC, resulting in both service and economic impacts. These data probably underestimate the true IC impact as it does not account for individuals with IC coded as general septicaemia. The difference in mean costs is also likely to be higher when excess bed day HRG costs and ICU per diem costs are included.

CHKS matched pair analysis results

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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