Clostridium difficile-Associated Disease May Cost the U.S. Healthcare System More than $1 Billion Annually

ARLINGTON, Va. -- Clostridium difficile-associated disease (CDAD) is a bacterial infection that causes diarrhea and is most commonly associated with recent exposure to both antibiotics and hospitals, nursing homes, or other healthcare institutions. For years, the annual number of CDAD cases has been increasing. Each case of CDAD may cost over $7,000, according to a new study by researchers at the Washington University School of Medicine and the Centers for Disease Control and Prevention (CDC). The study is published in the Feb. 15 issue of Clinical Infectious Diseases, currently available online. This study examined CDAD cases at a St. Louis hospital in 2003.

The authors analyzed the records of over 24,000 non-surgical patients admitted to the hospital in 2003 and found 439 cases of CDAD. They used two different statistical methods to determine both the per-episode costs as well as the costs over the subsequent six months.  The per-episode costs of CDAD were estimated at $2,454 to $3,240 and the costs over the subsequent six months were estimated at $5,042 to $7,179. If the cost estimates are extrapolated to cover the estimated number of CDAD cases throughout the U.S. in 2003, then the expense to the nations hospitals that year may have been as much as $1.3 billion.

Author Erik Dubberke, MD, of the Washington University School of Medicine, said, An important and novel feature of this study was that it was the first to evaluate CDAD attributable costs beyond a patient's initial CDAD hospitalization. CDAD continued to be an important predictor of increased costs beyond a patient's initial hospitalization.  The true costs are likely higher than our estimates as our methods were very conservative and we did not include costs from other acute care hospitals, long-term care facilities, outpatient clinic visits, outpatient medication use, or costs from loss of work due to CDAD. CDAD likely poses a significant financial burden to our healthcare system and to society in general.

Because CDAD rates and the severity of CDAD in the U.S. are increasing, said Dubberke, the financial burden of CDAD is likely increasing as well.  The significant attributable costs of CDAD stress the need to allocate more funding for research targeted at CDAD prevention and control.

Source: Infectious Diseases Society of America (IDSA)