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

  • Soline Leblanc (a1), Cécile Blein (a1), Antoine Andremont (a2) (a3) (a4), Pierre-Alain Bandinelli (a5) and Thibaut Galvain (a5)...
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

Copyright
Corresponding author
Address correspondence to Thibaut Galvain, Da Volterra, 172 rue de Charonne 75011 Paris, France (thibaut.galvain@davolterra.com).
Footnotes
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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.

Footnotes
References
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