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Burden of Clostridium difficile Infections in French Hospitals in 2014 From the National Health Insurance Perspective

Published online by Cambridge University Press:  15 June 2017

Soline Leblanc
Affiliation:
Heva, Lyon, France
Cécile Blein
Affiliation:
Heva, Lyon, France
Antoine Andremont
Affiliation:
Laboratoire de Bactériologie, Assistance Publique des Hôpitaux de Paris, Hôpital Bichat Claude Bernard, Paris, France Institut Nationale de la Santé et de la Recherche Médicale, Infection Antimicrobial Modelling Evolution, Unité Mixte de Recherche 1137, Sorbonne Paris Cité, Paris, France Université Paris Diderot, Infection Antimicrobial Modelling Evolution, Unité Mixte de Recherche 1137, Sorbonne Paris Cité, Paris, France
Pierre-Alain Bandinelli
Affiliation:
Da Volterra, Paris, France
Thibaut Galvain*
Affiliation:
Da Volterra, Paris, France
*
Address correspondence to Thibaut Galvain, Da Volterra, 172 rue de Charonne 75011 Paris, France (thibaut.galvain@davolterra.com).

Abstract

OBJECTIVE

To describe the hospital stays of patients with Clostridium difficile infection (CDI) and to measure the hospitalization costs of CDI (as primary and secondary diagnoses) from the French national health insurance perspective

DESIGN

Burden of illness study

SETTING

All acute-care hospitals in France

METHODS

Data were extracted from the French national hospitalization database (PMSI) for patients covered by the national health insurance scheme in 2014. Hospitalizations were selected using the International Classification of Diseases, 10 th revision (ICD-10) code for CDI. Hospital stays with CDI as the primary diagnosis or the secondary diagnosis (comorbidity) were studied for the following parameters: patient sociodemographic characteristics, mortality, length of stay (LOS), and related costs. A retrospective case-control analysis was performed on stays with CDI as the secondary diagnosis to assess the impact of CDI on the LOS and costs.

RESULTS

Overall, 5,834 hospital stays with CDI as the primary diagnosis were included in this study. The total national insurance costs were €30.7 million (US $33,677,439), and the mean cost per hospital stay was €5,267±€3,645 (US $5,777±$3,998). In total, 10,265 stays were reported with CDI as the secondary diagnosis. The total national insurance additional costs attributable to CDI were estimated to be €85 million (US $93,243,725), and the mean additional cost attributable to CDI per hospital stay was €8,295±€17,163, median, €4,797 (US $9,099±$8,827; median, $5,262).

CONCLUSION

CDI has a high clinical and economic burden in the hospital, and it represents a major cost for national health insurance. When detected as a comorbidity, CDI was significantly associated with increased LOS and economic burden. Preventive approaches should be implemented to avoid CDIs.

Infect Control Hosp Epidemiol 2017;38:906–911

Type
Original Articles
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. The results of this study were presented during an oral communication at the Réunion Interdisciplinaire de Chimiothérapie Anti-infectieuse (RICAI) 2016 on December 13, 2016, in Paris, France.

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