The cost of Clostridium difficile infection (CDI) in hospital in Italy

Il Costo Ospedaliero di Trattamento di un Episodio di Infezione da Clostridium Difficile in Italia

Abstract

Objective To describe characteristics, resource utilization and cost for patients experiencing a primary episode of CDI and recurrent CDI. Methods A retrospective observational cohort study was conducted. CDI data were collected with an electronic case report form (CRF) from five Hospitals in Italy. Hospitals collected all resource use attributable to CDI during the period 2011-2014. All resource use from initial presentation to the healthcare provider for CDI symptoms, until resolution of infection attributable to CDI in each enrolled patient was included. The patient cohort was analysed both as a whole and in stratified subgroups (by age, gender and co-morbidities). The impact of CDI on hospital length of stay (LOS) was used to calculate CDI-attributable costs. The total cost of a CDI episode was estimated by multiplying each resource used by its unit cost (national tariffs and market prices); finally, the mean cost/patient was calculated across the cohort. Results In total, data were collected for 488 adult infected patients (mean age 76.0 years [SD ± 15.48]; female 56.6%). Five hundred and three (503) episodes were evaluated (mean number per patient: 1.03 [SD ± 0.23]). LOS attributable to CDI was 14.6 days (SD ± 13.14). Attributable cost per adult patient was €10,224.08 (SD ± €8,963.86), with the majority of the cost being due to hospitalization. The mean cost of a recurrent episode of CDI was €9,504.87 [SD ± €8,614.11]. Conclusions These findings show that the economic burden of CDI is considerable in Italy. The most important cost driver was the LOS attributable to CDI.