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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2016

Open Access 01-12-2016 | Research article

Cost of hospital management of Clostridium difficile infection in United States—a meta-analysis and modelling study

Authors: Shanshan Zhang, Sarah Palazuelos-Munoz, Evelyn M. Balsells, Harish Nair, Ayman Chit, Moe H. Kyaw

Published in: BMC Infectious Diseases | Issue 1/2016

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Abstract

Background

Clostridium difficile infection (CDI) is the leading cause of infectious nosocomial diarrhoea but the economic costs of CDI on healthcare systems in the US remain uncertain.

Methods

We conducted a systematic search for published studies investigating the direct medical cost associated with CDI hospital management in the past 10 years (2005–2015) and included 42 studies to the final data analysis to estimate the financial impact of CDI in the US. We also conducted a meta-analysis of all costs using Monte Carlo simulation.

Results

The average cost for CDI case management and average CDI-attributable costs per case were $42,316 (90 % CI: $39,886, $44,765) and $21,448 (90 % CI: $21,152, $21,744) in 2015 US dollars. Hospital-onset CDI-attributable cost per case was $34,157 (90 % CI: $33,134, $35,180), which was 1.5 times the cost of community-onset CDI ($20,095 [90 % CI: $4991, $35,204]). The average and incremental length of stay (LOS) for CDI inpatient treatment were 11.1 (90 % CI: 8.7–13.6) and 9.7 (90 % CI: 9.6–9.8) days respectively. Total annual CDI-attributable cost in the US is estimated US$6.3 (Range: $1.9–$7.0) billion. Total annual CDI hospital management required nearly 2.4 million days of inpatient stay.

Conclusions

This review indicates that CDI places a significant financial burden on the US healthcare system. This review adds strong evidence to aid policy-making on adequate resource allocation to CDI prevention and treatment in the US. Future studies should focus on recurrent CDI, CDI in long-term care facilities and persons with comorbidities and indirect cost from a societal perspective. Health-economic studies for CDI preventive intervention are needed.
Appendix
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Metadata
Title
Cost of hospital management of Clostridium difficile infection in United States—a meta-analysis and modelling study
Authors
Shanshan Zhang
Sarah Palazuelos-Munoz
Evelyn M. Balsells
Harish Nair
Ayman Chit
Moe H. Kyaw
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2016
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-1786-6

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