Recently, a group of interdisciplinary researchers from the University of Toronto (UT) released study findings from a systematic review of currently published research on inflammatory bowel disease and other diseases that showed the economic burden that is a consequence of the growing rate of Clostridium difficile (C. diff) infection seen throughout the healthcare systems in developed countries. The study, entitled, “The Economic Impact of Clostridium difficile Infection: A Systematic Review,” was published on-line in the April edition of the American Journal of Gastroenterology.
C.diff is a spore-forming, bacterium that produces toxins that lead to a range of C. diff-associated disease (CDAD) states in humans such as mild diarrhea, colitis and possibly death. According to the CDC, antimicrobial use is the primary risk factor for development of CDAD for it disrupts normal bowel flora and promotes C. diff overgrowth. C. diff typically affects older or severely ill patients who are hospital inpatients or residents of long-term-care facilities. Recently, however, both the frequency and severity of health-care-associated CDAD has increased substantially. This increase has led to a significant increase in both fiscal and human resource utilization in healthcare.
To understand the precise economic burden that is a consequence of this increase in resource utilization the investigators systematically reviewed the current medical literature that looked at the cost-of-illness (COI) associated with C.diff.
They identified 45 studies between 1988 and June 2014 (with the majority published between 2011-2013) that fit the review criteria. These included:
- 84% of the studies were conducted by researchers in the United States
- 87% calculated costs of hospital stays
- All of the studies focused on direct costs
The results from the review analysis showed that the mean attributable costs of C.diff per hospitalized patient ranged from $8,911 to $30,049; with hospital length of stay being the largest cost driver in comparison with laboratory investigations and drug therapies.
When discussing the important contribution to the literature that this review provides, the authors wrote, “With C. diff infections increasing in frequency and severity, it is important to estimate the economic burden. Decision-makers can use cost-of-illness studies to aid in strategic planning, and researchers can incorporate [cost-of-illness] estimates in economic evaluations that, in turn, inform health policy. These recommendations will provide high-quality cost evidence to aid decisions on treatment (e.g., new antibiotics, fecal microbiota transplantation) and prevention (e.g., cleaning devices, antibiotic stewardship programs) strategies.”
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