Gabriel L, Beriot-Mathiot A
Institute of Pharmaceutical and Biological Sciences, University Lyon 1, Lyon, France.
Sanofi Pasteur, Lyon, France.
J Hosp Infect. 2014 Sep;88(1):12-21. doi: 10.1016/j.jhin.2014.04.011. Epub 2014 May 17.
In most healthcare systems, third-party payers fund the costs for patients admitted to hospital for Clostridium difficile infection (CDI) whereas, for CDI cases arising as complications of hospitalization, not all related costs are refundable to the hospital. We therefore aimed to critically review and categorize hospital costs and length of hospital stay (LOS) attributable to Clostridium difficile infection and to investigate the economic burden associated with it. A comprehensive literature review selected papers describing the costs and LOS for hospitalized patients as outcomes of CDI, following the use of statistics to identify costs and LOS solely attributable to CDI. Twenty-four studies were selected. Estimated attributable costs, all ranges expressed in US dollars, were $6,774-$10,212 for CDI requiring admission, $2,992-$29,000 for hospital-acquired CDI, and $2,454-$12,850 where no categorization was made. The ranges for LOS values were 5-13.6, 2.7-21.3, and 2.8-17.9 days, respectively. The categorization of CDI attributable costs allows budget holders to anticipate the cost per CDI case, a perspective that should enrich the design of appropriate incentives for the various budget holders to invest in prevention so that CDI prevention is optimized globally.
在大多数医疗保健系统中，第三方支付者为因艰难梭菌感染（CDI）入院的患者支付费用，然而，对于因住院并发症而出现的CDI病例，并非所有相关费用都可退还给医院。因此，我们旨在严格审查并分类归因于艰难梭菌感染的医院成本和住院时间（LOS），并调查与之相关的经济负担。一项全面的文献综述筛选出描述住院患者因CDI导致的成本和住院时间的论文，通过统计方法确定仅归因于CDI的成本和住院时间。共选取了24项研究。估计的归因成本（均以美元表示）为：因CDI需要入院的为6774美元至10212美元，医院获得性CDI为2992美元至29000美元，未分类的为2454美元至12850美元。住院时间值的范围分别为5至13.6天、2.7至21.3天和2.8至17.9天。对CDI归因成本进行分类使预算管理者能够预估每个CDI病例的成本，这一视角应丰富为各类预算管理者设计适当激励措施的思路，促使他们投资于预防工作，从而在全球范围内优化CDI的预防工作。
