Skip to content

Research at St Andrews

Cost burden of Clostridioides difficile infection to the health service: a retrospective cohort study in Scotland

Research output: Contribution to journalArticle

Open Access Status

  • Embargoed (until 24/07/21)

Author(s)

Chris Robertson, Jiafeng Pan, Kim Kavanagh, Ian Ford, Colin McCowan, Marion Bennie, Charis Marwick, Alistair Leanord

School/Research organisations

Abstract

Background

Clostridioides difficile infection (CDI) is associated with high healthcare demands and related costs.

Aim

To evaluate the healthcare and economic burden of CDI in hospitalised patients with community- (HOCA-CDI) or hospital-associated CDI (HOHA-CDI) in the National Health Service in Scotland.

Methods

A retrospective cohort study was conducted, examining data between August 2010 and July 2013 from four patient-level Scottish datasets, linked to death data. Data examined included prior antimicrobial prescriptions in the community, hospitalisations, length of stay and mortality. Each CDI case was matched to three hospital-based controls on the basis of age, gender, hospital and date of admission. Descriptive economic evaluations were based on bed-day costs for different types of wards.

Findings

Overall, 3304 CDI cases were included in the study. CDI was associated with additional median lengths of stay of 7.2 days for HOCA-CDI and 12.0 days for HOHA-CDI compared with their respective, matched controls. The 30-day mortality rate was 6.8% for HOCA-CDI and 12.4% for HOHA-CDI. Overall, recurrence within 90 days of the first CDI episode occurred in 373/2740 (13.6%) survivors. The median additional expenditure for each initial CDI case compared with matched controls was £1713. In the 6 months after the index hospitalisation, the cost associated with a CDI case was £5126 higher than for controls.

Conclusion

Using routinely collected national data, we demonstrate the substantial burden of CDI on healthcare services, including lengthy hospital stays and readmissions, which increase the costs of managing patients with CDI compared with matched controls.

Close

Details

Original languageEnglish
JournalJournal of Hospital Infection
VolumeIn press
Early online date24 Jul 2020
DOIs
Publication statusE-pub ahead of print - 24 Jul 2020

    Research areas

  • Clostridioides (Clostridium) difficle infection, Cost burden, Hospital infection, Community infection, Retrospective cohort

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Impact of COVID-19 on accident and emergency attendances and emergency and planned hospital admissions in Scotland: an interrupted time-series analysis

    Mulholland, R. H., Wood, R., Stagg, H. R., Fischbacher, C., Villacampa, J., Simpson, C. R., Vaseleiou, E., McCowan, C., Stock, S. J., Docherty, A. B., Ritchie, L. D., Agrawal, U., Robertson, C., Murray, J. L. K., MacKenzie, F. & Sheikh, A., 4 Oct 2020, In : Journal of the Royal Society of Medicine. Online First

    Research output: Contribution to journalArticle

  2. Changes over a decade in psychotropic prescribing for people with intellectual disabilities: prospective cohort study

    Henderson, A., Mcskimming, P., Kinnear, D., McCowan, C., McIntosh, A., Allan, L. & Cooper, S. A., 10 Sep 2020, In : BMJ Open. 10, 9, 9 p., e036862.

    Research output: Contribution to journalArticle

  3. Earlier diagnosis of lung cancer in a randomised trial of an autoantibody blood test followed by imaging

    Sullivan, F. M., Mair, F. S., Anderson, W., Armory, P., Briggs, A., Chew, C., Dorward, A., Haughney, J., Hogarth, F., Kendrick, D., Littleford, R., Mcconnachie, A., McCowan, C., Mcmeekin, N., Patel, M., Rauchhaus, P., Ritchie, L., Robertson, C., Robertson, J., Robles-Zurita, J. & 8 others, Sarvesvaran, J., Sewell, H., Sproule, M., Taylor, T., Tello, A., Treweek, S., Vedhara, K. & Schembri, S., 30 Jul 2020, In : European Respiratory Journal. Early View, 2000670.

    Research output: Contribution to journalArticle

  4. Linkage of national health and social care data: a cross-sectional study of multimorbidity and social care use in people aged over 65 years in Scotland

    Henderson, D. A. G., Atherton, I., McCowan, C., Mercer, S. W. & Bailey, N., 16 Jul 2020, In : Age and Ageing. Advance Article, 7 p., afaa134.

    Research output: Contribution to journalArticle

  5. Rates, causes, place and predictors of mortality in adults with intellectual disabilities with and without Down syndrome: cohort study with record linkage

    Cooper, S-A., Allan, L., Greenlaw, N., McSkimming, P., Jasilek, A., Henderson, A., McCowan, C., Kinnear, D. & Melville, C., 17 May 2020, In : BMJ Open. 10, 5, 12 p., e036465.

    Research output: Contribution to journalArticle

Related by journal

  1. Pseudomonas aeruginosa intensive care unit outbreak: winnowing of transmissions with molecular and genomic typing

    Parcell, B. J., Oravcova, K., Pinheiro, M., Holden, M. T. G., Phillips, G., Turton, J. F. & Gillespie, S. H., Mar 2018, In : Journal of Hospital Infection. 98, 3, p. 282-288 7 p.

    Research output: Contribution to journalArticle

  2. Hydrogen peroxide vapour decontamination of surfaces artificially contaminated with norovirus surrogate feline calicivirus

    Bentley, K., Dove, B. K., Parks, S. R., Walker, J. T. & Bennett, A. M., Feb 2012, In : Journal of Hospital Infection. 80, 2, p. 116-21 6 p.

    Research output: Contribution to journalArticle

  3. Molecular strain typing of M. tuberculosis isolates from a suspected outbreak involving a faulty bronchoscope [3]

    Shorten, R. J., Gillespie, S. H., Sule, O., Lipman, M. & McHugh, T. D., 1 Sep 2005, In : Journal of Hospital Infection. 61, 1, p. 86-87 2 p.

    Research output: Contribution to journalLetter

ID: 269484556

Top