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Resource use and costs associated with Clostridium difficile diarrhoea in a university hospital

Abstract number: P1435

Agthe N., Mattila E., Anttila V.J., Kanerva M.

Objectives:C. difficile is one of the most common healthcare-associated infections. It is also associated with increased resource use and costs. We wanted to study the incidence and the economic burden caused by C. difficile in the Helsinki University Central hospital during Feb 2007-May 2008.

Methods: We conducted laboratorio-based prospective surveillance of healthcare-associated C. difficile incidence at six acute care wards during a 16 months' study period, and reviewed the patient records for symptoms, diagnostic tests and treatment. A case was defined as a symptomatic patient with positive stool sample for C. difficile between 3 days after admission and 4 weeks after discharge, and symptoms associated with infection. The data of the resource use was gathered from the patient records. Prolongation of hospital stay was analyzed by appropriateness evaluation protocol (AEP) method. Unit costs for bed days, isolation, diagnostic tests and medication were obtained from the literature, hospital administration, laboratory and pharmacy.

All incremental resource use and costs caused by C. difficile infection from hospital perspective were calculated for those patients who were in the hospital at the time of symptoms.

Results: The monthly incidence of the C. difficile infection varied between the study wards throughout the study period from 0.7 to 3.8 cases/1000 patient days. Altogether 72 patients were included in the cost analyses. The average incremental costs associated with C. difficile infection was 2300 [euro]/patient, but the cost data was highly skewed. Incremental cost for hospital were 165 000 [euro] during study period (approximately 1700 [euro]/month/ward). C. difficile infection prolonged the stay by a mean of 2.7 days. Most of the recourse use came from extra days (85%). Other cost drivers were incremental ICU days (6%), laboratory (4.5%), medication (1.4%) costs and isolation (1.2%).

Conclusion: Healthcare-associated C. difficile infection caused significant extra costs for the hospital mostly due to prolongation of hospital stay.

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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