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

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

doi:10.1186/s12879-016-1786-6

Table 3 CDI-attributable costs/charges and CDI-related management costs/charges

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

Author, Year	Population	Outcome	Statistic	Incremental CDI-attributable cost/charges				CDI-related cost/charges				Note
Author, Year	Population	Outcome	Statistic	Sample size	Attributable cost 2015$	SD or 95 % CI		Sample size	CDI only cost 2015$	SD, 95 % CI or IQR		Note
CO-CDI Inpatient Cost
Arora 2011 [29]	General	Cost	Median	85	25,436			85	25,436
O’Brien 2007 [51]	General	Cost	Mean	4015	14,736			4015	14,736
Peery 2012 [56]	General	Cost	Median	110,553	7513			110,553	7513
VeerLee 2012 [64]	General	Charges	Mean	68,686	74,211	120,156		68,686	74,211	120,156
Kuntz 2012 [41]	General	Cost	Mean	1650	929	4800		1650	929	4800		Outpatient
Kuntz 2012 [41]	General	Cost	Mean	1316	11,877	35,923		1316	11,877	35,923		Inpatient
O’Brien 2007 [51]	General	Cost	Median	1036	7263			1036	7263			PD
VeerLee 2012 [64]	General	Charges	Mean	17,413	27,463	40,484		17,413	27,463	40,484		PD
O’Brien 2007 [51]	General	Cost	Mean	3327	16,946	34,655		3327	16,946			Rehospitalisation
Sammons 2013 [59]	Children	Cost	Mean	2060	19,993	15,973	24,013	2060	19,993	15,973	24,013	Community onset
Ananthakrishnan 2008 [28]	IBD	Charges	Median					44,400	16,864			CDI only
Pant 2013 [55]	IBD	Charges	Mean	12,610	12,761	6868	18,655	447	50,050			CDI only
Bajaj 2010 [30]	Cirrhosis	Charges	Mean					58,220	70,309			CDI only
Quimbo 2013 [57]	CDI History	Cost	Mean	1866	29,662	20,798	42,300	933	51,863	36,641	73,411	CDI only
Total numbers/Weighted Mean				224,617	20,085			314,141	23,322
HO-CDI Inpatient Cost
Fuller 2009 [37]	General	Cost	Coefficient	1282	18,466	288		1282	18,466	288		Maryland, SD
Fuller 2009 [37]	General	Cost	Coefficient	2478	29,980	271		2478	29,980	271		California, SD
Lipp 2012 [46]	General	Cost	Mean	3826	32,050			3826	32,050			SD
McGlone 2012 [48]	General	Cost	Median	54,046	10,016	8547	12,055	54,046	10,016	8547	12,055	SD Cost-hospital perspective-6 days LOS
McGlone 2012 [48]	General	Cost	Median	54,046	11,116	9476	13,366	54,046	11,116	9476	13,366	10 days LOS
McGlone 2012 [48]	General	Cost	Median	54,046	12,194	10,146	14,896	54,046	12,194	10,146	14,896	14 days LOS
O’Brien 2007 [51]	General	Cost	Median	2656	6630			2656	6630			SD
VeerLee 2012 [64]	General	Charges	Mean	51,273	90,202	146,767		51,273	90,202	146,767		SD
Jiang 2013 [39]	General	Cost	Median	7264	11,689			1211	21,751
Pakyz 2011 [52]	General	Cost	Mean	30,071	31,180			10,857	64,732			Unadjusted
Pakyz 2011 [52]	General	Cost	Median	30,071	24,456			10,857	39,598	22,400	88,537	Unadjusted
Pakyz 2011 [52]	General	Cost	Mean	30,071	31,169			10,857	64,000	63,541	64,458	Adjusted
Tabak 2013 [63]	General	Cost	Mean	1020	6893	1365	13,617	255	22,992	12,222	42,470
Campbell 2013 [31]	Age > = 65	Cost	Mean	3064	7536	4302	10,771	3064	48,932	67,727
Quimbo 2013 [57]	Elderly	Cost	Mean	34,732	45,749	43,279	48,359	10,933	83,004	78,548	87,713
Sammons 2013 [59]	Children	Cost	Mean	2414	99,012	84,626	113,398	2414	99,012	84,626	113,398
Ananthakrishnan 2008 [28]	IBD	Charges	Median	80,170	7655			2804	24,623
Ananthakrishnan 2008 [28]	IBD	Charges	Mean	80,170	14,368	9467	19,270	–
Campbell 2013 [31]	IBD	Cost	Mean	84	1522	−14,932	11,888	84	40,194	44,845
Quimbo 2013 [57]	IBD	cost	Mean	3618	11,825	9851	14,181	1206	42,035	35,918	49,191
Ananthakrishnan 2008 [28]	Ulcerative colitis (UC)	Charges	Median					1843	26,750
Nguyen 2008 [49]	UC	Charges	Mean	43,645	14,749			196	43,381			Regression
Ananthakrishnan 2008 [28]	Crohn's disease (CD)	Charges	Median					961	22,738
Nguyen 2008 [49]	CD	Charges	Mean	73,197	14,316			329	41,453			Regression
Reed 2008	Digestive disorders	Charges	Mean	2394	3670			320	9076	8068
Damle 2014 [14]	Colorectal surgery	Cost	Median	84,648	14,644	13,700	15,589	1266	21,309	38,218		–
Kim 2012 [40]	Cystectomy	Cost	Mean	10,856	25,014			153	57,379	50,204	64,554
Lesperance 2011 [45]	Elective colonic resection	Charges	Mean	695,010	84,899			10,077	158,401
Reed 2008	Major bowel procedures	Charges	Mean	1035	25,476			45	47,064	31,302
Wilson 2013 [66]	Ileostomy	Cost	Mean	13,462	20,272			217	35,076
Wilson 2013 [66]	Ileostomy	Cost	Coefficient	13,462	17,513	14,106	20,921
Egorova 2015 [35]	Vascular surgery	Cost	Median	450,251	14,250			4708	36,847	22,912	62,903
Flagg 2014 [36]	Cardiac surgery	Cost	Median	5160	19,524			2580	213,661			Adjusted
Flagg 2014 [36]	Cardiac surgery	Cost	Median	349,122	38,320			2580	72,730			Unadjusted
Lemaire 2015 [43]	Cardiac surgery	Cost	Median	421,294	35,968			–	72,685			CABG
Lemaire 2015 [43]	Cardiac surgery	Cost	Median	90,923	59,696			–	106,141			VS
Reed 2008	OR procedure for infectious /parasitic diseases	Charges	Mean	449	7462			32	35,524	25,498
Glance 2011 [38]	Trauma	Cost	Median	149,656	24,131			768	39,296
Campbell 2013 [31]	Cabx	Cost	Mean	1641	18,567	10,448	26,687	1641	78,948	99,739
Quimbo 2013 [57]	Cabx	Cost	Mean	17,716	38,413	35,195	41,922	4429	64,242	59,145	69,780
Lagu 2014 [42]	Sepsis	Cost	Median	4736	5792	4933	6665	2368	28,576	16,496	50,494
Reed 2008	Septicaemia	Charges	Mean	1211	9141			92	22,378	20,591
Campbell 2013 [31]	Renal impairment	Cost	Mean	3236	5024	1118	8928	3236	50,586	72,180
Quimbo 2013 [57]	RI	Cost	Mean	22,132	122,318	111,315	134,405	5533	201,212	183,706	220,386
Ali 2012 [27]	Liver transplant	Charges	Mean	193,714	77,361			5159	158,038
Singal 2014 [60]	Cirrhosis	Charges	Mean	89,673	23,310			1444	47,401
Reed 2008	Congestive Heart Failure	Charges	Mean	2542	7332			35	14,738	13,841
Quimbo 2013 [57]	Immunocompromised	Cost	Mean	14,344	33,632	30,151	37,516	3586	73,612	66,048	82,041
Campbell 2013 [31]	Cancer/BMT	Cost	Mean	782	687	−6480	7855	782	48,280	72,605
Total numbers/Weighted mean				3,020,827	34,149			207,801	49,712
Dubberke 2014 [2, 34, 71]	Recurrent CDI	Cost	Mean	3958	12,163			3958	11,523	4728	26,167	Total cost difference
Dubberke 2014 [2, 34, 71]	Recurrent CDI	Cost	Mean	3958	12,692	9752	15,919					Adjusted
Song 2008 [61]	General	Cost	Median	1260	373			630	30,305
Stewart 2011 [62]	General	Cost	Mean	82,414	9670			41,207	26,790
Wang 2011 [65]	General	Cost	Median	7,227,788	4914			78,273	12,081
Nylund 2011 [50]	Children	Charges	Median	3565	15,937			3565	25,549			1997
Nylund 2011 [50]	Children	Charges	Median	4356	20,750			4356	31,858			2000
Nylund 2011 [50]	Children	Charges	Median	5574	23,627			5574	33,625	11,348	97,822	2003
Nylund 2011 [50]	Children	Charges	Median	7779	23,362			7779	35,444	13,601	110,343	2006
Sammons 2013 [59]	Children	Cost	Mean	698,616	51,304	44,746	57,969	698,616	51,304	44,746	57,969
Dubberke 2008 [33]	Non-surgical	Cost	Median	24,691	11,749			439	20,569			Raw data
Dubberke 2008 [33]	Non-surgical	Charges	Median	24,691	23,961			439	42,154			Raw data
Dubberke 2008 [33]	Non-surgical	Cost	Mean	24,691	3173	3078	3815					Linear regression
Dubberke 2008 [33]	Non-surgical	Cost	Median	24,691	4190			342	18,842			Matched cases
Dubberke 2008 [33]	Non-surgical	Cost	Mean	24,691	6520	4910	8381					Linear regression, 180 days
Dubberke 2008 [33]	Non-surgical	Cost	Median	24,691	9284			342	35,414			Matched cases, 180 days
Zerey 2007 [67]	Surgical	Charges	Median	1,553,597	59,424			8113	81,708
Zerey 2007 [67]	Surgical	Charges	Coefficient	1,553,597	94,402	91,589	97,216					Multivariate regression analysis
Zilberberg 2009 [68]	Prolonged acute mechanical ventilation (PAMV)	Cost	Median	64,910	48,065			3468	190,188	107,689	333,290	Unadjusted
Zilberberg 2009 [68]	PAMV	Cost	Mean	3370	12,616	9186	16,046	3468	91,039	71,306		Adjusted
Lawrence 2007 [44]	ICU	Cost	Median	1872	7043			76	15,016			ICU stay
Lawrence 2007 [44]	ICU	Cost	Median	1872	36,095			76	60,723			Entire hospital stay
Bajaj 2010 [30]	Cirrhosis	Charges	Mean	83,230	49,460			1165	96,678
Maltenfort 2013 [47]	Arthroplasty	Charges	Median	–	43,648			–	84,877	52,498	142,827
Pant 2012 [53]	Organ transplant	Charges	Mean	49,198	77,246	73,412	81,080	63,651	42,054	69,033
Pant 2012 (2) [54]	Renal disease	Charges	Coefficient	184,139	69,679	68,338	71,020	59,793	87,982
Pant 2013 [55]	IBD	Charges	Mean	12,610	39,453	32,470	46,436
Total numbers/Weighted Mean				10,012,927	14,403			981,005	45,421

Abbreviations: CO-CDI community-onset CDI, HO-CDI hospital-onset, PAMV prolonged acute mechanical ventilation, Cabx concomitant antibiotic use, UC ulcerative colitis, CD Crohn’s disease, IBD inflammatory bowel disease, ICU intensive care unit, CABG coronary artery bypass grafting, VS valvular surgery, BMT, PD primary diagnosis, SD secondary diagnosis, Calculated numbers were marked in Italic, attributable cost = cost of CDI group- cost of control non-CDI group

Back to article page

ISSN: 1471-2334

Contact us

Submission enquiries: bmcinfectiousdiseases@biomedcentral.com
General enquiries: ORSupport@springernature.com

BMC Infectious Diseases

Contact us