Impact of hospital admission for Clostridioides difficile infection on costs (adjusted to 2015 Canadian dollars) 180 and 365 days after admission stratified by association and onset
| Item† | Cost, $* | |||||||
|---|---|---|---|---|---|---|---|---|
| ACH-associated | LTCF-associated | Community-associated | ACH-associated/community-onset | |||||
| Cohort | Control group | Cohort | Control group | Cohort | Control group | Cohort | Control group | |
| 180 d after admission | ||||||||
| Inpatient hospital stays | ||||||||
| Median (IQR) | 36 370 (19 700–72 050) | 8270 (4977–15 118) | 10 512 (5605–17 358) | 0 (0–0) | 13 249 (6106–28 465) | 0 (0–0) | 19 948 (10 793–40 147) | 8031 (4815–16 231) |
| Mean ± SD | 60 634.46 ± 71 778.71 | 15 040.39 ± 26 077.94 | 16 204.58 ± 24 121.61 | 1686.52 ± 6180.19 | 26 078.24 ± 39 508.03 | 1521.96 ± 7627.97 | 34 061.46 ± 45 162.54 | 16 579.24 ± 29 053.97 |
| Emergency department visits | ||||||||
| Median (IQR) | 611 (0–902) | 559 (0–789) | 668 (0–829) | 0 (0–126) | 635 (167–958) | 0 (0–0) | 619 (0–915) | 548 (0–752) |
| Mean ± SD | 666.89 ± 766.98 | 518.66 ± 495.71 | 617.35 ± 640.14 | 181.46 ± 420.58 | 708.21 ± 677.24 | 150.72 ± 423.95 | 724.86 ± 851.88 | 500.98 ± 478.89 |
| Outpatient medications‡ | ||||||||
| Median (IQR) | 192 (0–1038) | 146 (0–936) | 318 (42–1583) | 1646 (957–2434) | 278 (0–1224) | 332 (0–986) | 64 (0–1114) | 13 (0–683) |
| Mean ± SD | 842.03 ± 2378.90 | 732.77 ± 1717.44 | 968.89 ± 1267.01 | 1781.81 ± 1152.34 | 1008.56 ± 2414.25 | 789.91 ± 2695.40 | 923.58 ± 2092.82 | 669.52 ± 1941.53 |
| Physician services | ||||||||
| Median (IQR) | 4579 (2592–8324) | 1788 (951–3234) | 1430 (832–2478) | 679 (515–988) | 2338 (1322–4465) | 310 (76–849) | 2808 (1412–5433) | 1586 (828–2802) |
| Mean ± SD | 6827.81 ± 6945.65 | 577.23 ± 2830.52 | 2064.48 ± 2598.27 | 929.47 ± 1013.78 | 3667.64 ± 4133.96 | 776.38 ± 1437.33 | 4191.95 ± 4453.04 | 2367.13 ± 2772.78 |
| Total costs | ||||||||
| Median (IQR) | 48 593 (27 707–92 417) | 13 542 (8372–23 576) | 13 951 (8756–23 048) | 2995 (1942–4622) | 20 258 (10 658–41 263) | 1144 (300–3234) | 28 486 (16 058–53 697) | 13 557 (8100–25 203) |
| Mean ± SD | 74 496.36 ± 78 111.95 | 21 833.49 ± 30 088.58 | 20 760.15 ± 27 362.89 | 5355.20 ± 9468.88 | 35 458.34 ± 45 345.38 | 4264.40 ± 11 330.13 | 44 738.49 ± 51 144.10 | 23 616.52 ± 33 062.58 |
| 365 d after admission | ||||||||
| Inpatient hospital stays | ||||||||
| Median (IQR) | 38 832 (21 256–76 985) | 8391 (4999–15 430) | 10 829 (5605–18 865) | 0 (0–0) | 15 218 (6959–32 952) | 0 (0–0) | 21 765 (11 468–46 265) | 8159 (4862–16 938) |
| Mean ± SD | 67 121.13 ± 90 699.65 | 15 446.71 ± 28 373.96 | 17 669.40 ± 32 455.65 | 2881.96 ± 8133.05 | 29 809.12 ± 47 241.81 | 3164.33 ± 11 986.56 | 39 015.27 ± 53 837.57 | 17 185.72 ± 32 413.07 |
| Emergency department visits | ||||||||
| Median (IQR) | 678 (0–1151) | 588 (0–814) | 692 (0–913) | 0 (0–533) | 723 (388–1211) | 0 (0–357) | 678 (0–1 228) | 578 (0–794) |
| Mean ± SD | 867.96 ± 1118.86 | 577.73 ± 620.81 | 704.63 ± 735.94 | 330.35 ± 591.97 | 942.05 ± 987.16 | 307.38 ± 693.48 | 990.25 ± 1457.78 | 561.37 ± 610.01 |
| Outpatient medications‡ | ||||||||
| Median (IQR) | 396 (0–2153) | 215 (0–1709) | 332 (42–2729) | 3030 (1588–4666) | 518 (0–2432) | 685 (0–1980) | 96 (0–2084) | 25 (0–1078) |
| Mean ± SD | 1674.50 ± 4784.24 | 1331.64 ± 3036.82 | 1645.95 ± 2354.53 | 3347.08 ± 2305.86 | 1940.65 ± 4352.58 | 1579.82 ± 5241.77 | 1675.95 ± 3684.43 | 1166.97 ± 3654.67 |
| Physician services | ||||||||
| Median (IQR) | 5298 (2969–9701) | 2128 (1079–3807) | 1729 (886–2943) | 1366 (1007–1969) | 3077 (1668–5733) | 743 (231–1877) | 3307 (1615–6535) | 1798 (914–3327) |
| Mean ± SD | 7918.96 ± 8131.04 | 2967.15 ± 3144.92 | 2488.54 ± 3377.68 | 1711.19 ± 1539.40 | 4738.46 ± 5187.00 | 1538.04 ± 2393.55 | 5244.60 ± 5815.23 | 2726.24 ± 3317.25 |
| Total costs | ||||||||
| Median (IQR) | 54 169 (30 873–102 711) | 15 168 (9182–26 004) | 15 565 (9750–25 649) | 6232 (3732–9912) | 25 245 (12 873–51 066) | 2616 (721–7833) | 33 342 (17 487–65 334) | 14 837 (8710–28 267) |
| Mean ± SD | 86 882.61 ± 101 953.16 | 24 224.39 ± 34 851.75 | 24 114.74 ± 38 520.25 | 9942.79 ± 16 397.21 | 44 047.52 ± 58 622.89 | 8564.23 ± 19 207.29 | 54 170.54 ± 65 160.54 | 26 175.76 ± 39 323.83 |
Note: ACH = acute care hospital, IQR = interquartile range, LTCF = long-term care facility, SD = standard deviation.
↵* Shaded cells denote the statistical significance (p ≤ 0.05) of the standardized difference between the infection cohort and matched control patients.
↵† Costs for other services such as home care and same-day surgical procedures were excluded from the table but included in the total costs.
↵‡ Includes any prescription drugs purchased for outpatient use through the Ontario Drug Benefit plan. Costs are based on the total amount paid to the pharmacy (including pharmacy fees) from Ontario Ministry of Health and Long-Term Care.