Display options
Cite
Levy AR, Szabo SM, Lozano-Ortega G, et al. Incidence and Costs of Clostridium difficile Infections in Canada. Open Forum Infect Dis. 2015;2(3):ofv076doi: 10.1093/ofid/ofv076.
Levy, A. R., Szabo, S. M., Lozano-Ortega, G., Lloyd-Smith, E., Leung, V., Lawrence, R., & Romney, M. G. (2015). Incidence and Costs of Clostridium difficile Infections in Canada. Open forum infectious diseases, 2(3), ofv076. https://doi.org/10.1093/ofid/ofv076
Levy, Adrian R, et al. "Incidence and Costs of Clostridium difficile Infections in Canada." Open forum infectious diseases vol. 2,3 (2015): ofv076. doi: https://doi.org/10.1093/ofid/ofv076
Levy AR, Szabo SM, Lozano-Ortega G, Lloyd-Smith E, Leung V, Lawrence R, Romney MG. Incidence and Costs of Clostridium difficile Infections in Canada. Open Forum Infect Dis. 2015 Jun 03;2(3):ofv076. doi: 10.1093/ofid/ofv076. eCollection 2015 Sep. PMID: 26191534; PMCID: PMC4503917.
Copy Download .nbib Format: NLM
Share it on

Open Forum Infect Dis. 2015 Jun 03;2(3):ofv076. doi: 10.1093/ofid/ofv076. eCollection 2015 Sep.

Incidence and Costs of Clostridium difficile Infections in Canada.

Open forum infectious diseases

Adrian R Levy, Shelagh M Szabo, Greta Lozano-Ortega, Elisa Lloyd-Smith, Victor Leung, Robin Lawrence, Marc G Romney

Affiliations

  1. Department of Community Health and Epidemiology , Dalhousie University , Halifax, Nova Scotia , Canada ; Oxford Outcomes Ltd , Vancouver , Canada.
  2. Department of Community Health and Epidemiology , Dalhousie University , Halifax, Nova Scotia , Canada.
  3. St Paul's Hospital, Providence Health Care , Vancouver, British Columbia , Canada.
  4. St Paul's Hospital, Providence Health Care , Vancouver, British Columbia , Canada ; University of British Columbia , Vancouver , Canada.
  5. Cubist Pharmaceuticals , Toronto, Ontario , Canada.

PMID: 26191534 PMCID: PMC4503917 DOI: 10.1093/ofid/ofv076

Abstract

Background.  Limited data are available on direct medical costs and lost productivity due to Clostridium difficile infection (CDI) in Canada. Methods.  We developed an economic model to estimate the costs of managing hospitalized and community-dwelling patients with CDI in Canada. The number of episodes was projected based on publicly available national rates of hospital-associated CDI and the estimate that 64% of all CDI is hospital-associated. Clostridium difficile infection recurrences were classified as relapses or reinfections. Resource utilization data came from published literature, clinician interviews, and Canadian CDI surveillance programs, and this included the following: hospital length of stay, contact with healthcare providers, pharmacotherapy, laboratory testing, and in-hospital procedures. Lost productivity was considered for those under 65 years of age, and the economic impact was quantified using publicly available labor statistics. Unit costs were obtained from published sources and presented in 2012 Canadian dollars. Results.  There were an estimated 37 900 CDI episodes in Canada in 2012; 7980 (21%) of these were relapses, out of a total of 10 900 (27%) episodes of recurrence. The total cost to society of CDI was estimated at $281 million; 92% ($260 million) was in-hospital costs, 4% ($12 million) was direct medical costs in the community, and 4% ($10 million) was due to lost productivity. Management of CDI relapses alone accounted for $65.1 million (23%). Conclusions.  The largest proportion of costs due to CDI in Canada arise from extra days of hospitalization. Interventions reducing the severity of infection and/or relapses leading to rehospitalizations are likely to have the largest absolute effect on direct medical costs.

Keywords: Clostridium difficile; economic burden; epidemiology; hospital-acquired infections; model

References

  1. Can J Infect Control. 2009 Summer;24(2):109-15 - PubMed
  2. Curr Opin Gastroenterol. 2014 Jan;30(1):54-62 - PubMed
  3. Infect Control Hosp Epidemiol. 2007 Nov;28(11):1219-27 - PubMed
  4. Clin Infect Dis. 2009 Mar 1;48(5):568-76 - PubMed
  5. JPEN J Parenter Enteral Nutr. 2012 Nov;36(6):645-62 - PubMed
  6. Infect Control Hosp Epidemiol. 2009 Oct;30(10):945-51 - PubMed
  7. JAMA Intern Med. 2013 Jul 22;173(14):1359-67 - PubMed
  8. CMAJ. 2012 Jan 10;184(1):37-42 - PubMed
  9. Clin Infect Dis. 2006 Mar 15;42(6):758-64 - PubMed
  10. Pharmacoeconomics. 2006;24(11):1055-68 - PubMed
  11. Nat Genet. 2013 Jan;45(1):109-13 - PubMed
  12. Antimicrob Resist Infect Control. 2013 Jul 01;2(1):21 - PubMed
  13. Emerg Infect Dis. 2006 Mar;12(3):409-15 - PubMed
  14. N Engl J Med. 2005 Dec 8;353(23):2433-41 - PubMed
  15. Emerg Infect Dis. 2012 Mar;18(3):392-400 - PubMed
  16. Emerg Infect Dis. 2004 Apr;10(4):561-6 - PubMed
  17. Clin Infect Dis. 2007 Sep 1;45 Suppl 2:S112-21 - PubMed
  18. Emerg Infect Dis. 2007 Sep;13(9):1417-9 - PubMed
  19. MMWR Morb Mortal Wkly Rep. 2012 Mar 9;61(9):157-62 - PubMed
  20. Lancet Infect Dis. 2012 Apr;12(4):281-9 - PubMed
  21. Health Serv Manage Res. 2003 May;16(2):71-84 - PubMed
  22. Infect Control Hosp Epidemiol. 2009 Jan;30(1):57-66 - PubMed
  23. Int J Med Microbiol. 2010 Aug;300(6):387-95 - PubMed
  24. PLoS One. 2013 Nov 20;8(11):e79740 - PubMed
  25. N Engl J Med. 2011 Feb 3;364(5):422-31 - PubMed
  26. Infect Control Hosp Epidemiol. 2010 May;31(5):431-55 - PubMed
  27. N Engl J Med. 2015 Feb 26;372(9):825-34 - PubMed
  28. Lancet. 2005 Sep 24-30;366(9491):1079-84 - PubMed
  29. Am J Gastroenterol. 2012 Jan;107(1):89-95 - PubMed

Publication Types