Dr. Thibaut Galvain will present results of a study on CDI burden in French hospitals at RICAI in Paris next week, highlighting a major cost for public health insurance. This study clearly shows that when present as comorbidity, CDI significantly increases the length of the hospital stay and the economic burden supported by the French healthcare system. It definitely emphasises the need to implement preventive approaches to avoid CDIs.
Burden of Clostridium difficile infections in France in 2014
INTRODUCTION: High-quality estimates of the burden of Clostridium difficile infection (CDI) in hospitals are essential for healthcare policy and decision-making. This work aimed at describing hospital stays of patients with CDI and at measuring the hospitalization costs of CDI (as the primary diagnosis and as the secondary diagnosis) from the French public health insurance perspective.
METHODS: Data was extracted from the national hospitalization database (PMSI) for patients covered by the French public health insurance scheme. Hospitalizations were selected using the ICD-10 diagnosis code for CDI for year 2014. Hospital stays with CDI as the primary diagnosis or the secondary diagnosis (comorbidity) were studied for the following parameters: patient characteristics, mortality, length of stay and related costs. Then, a retrospective case-control analysis was performed on stays with CDI as the secondary diagnosis to assess the impact of CDI as comorbidity on the length of stay and costs.
RESULTS: 5,834 hospital stays were collected with CDI as the primary diagnosis (64 % of women, mean age: 68.6 ± 21.9 years and mean LOS: 11.7 ± 11 days). 370 patients (7.4%) died during hospitalization. The total public insurance costs were 30.7 M€ and the mean cost per hospital stay was 5,267 ± 3,645€. 10,265 stays were reported with CDI as the secondary diagnosis (53 % of women, mean age: 68.8 ± 20.5 years and mean LOS: 26.2 ± 28.5 days). The total public insurance additional costs attributable to CDI were 85 M€ and the mean additional cost attributable to CDI per hospital stay was 8,295 ± 17,163€.
CONCLUSION: CDIs have a very high clinical and economic burden in the hospital and represent a major cost for public health insurance. When present as comorbidity for other medical reasons, CDI significantly increases the length of the hospital stay and the economic burden supported by the French healthcare system. Preventive approaches should be implemented to avoid CDIs.
Keywords: Clostridium difficile infections, CDI, Cost, Economic burden, Hospital, Public insurance, Mortality.