title: Short- and long-term attributable costs of Clostridium difficile-associated disease in nonsurgical inpatients.
abstract: BACKGROUND
  The incidence of Clostridium difficile-associated disease (CDAD) is increasing. There are few data on the short-term and long-term attributable costs of CDAD. The objective of this study was to determine the acute and 180-day attributable inpatient costs of CDAD.
  
  
  METHODS
  We performed a retrospective cohort study of all patients without operating room costs who were admitted for > or =48 h to Barnes-Jewish Hospital, a tertiary care hospital in St. Louis, Missouri, 1 January 2003-31 December 2003 (n = 24,691). Attributable costs of CDAD were determined by multivariable linear regression and propensity-score matched-pairs analyses (n = 684) for the hospitalization in which CDAD occurred and per patient over a 180-day period, including the initial hospitalization.
  
  
  RESULTS
  CDAD was associated with $2454 (95% confidence interval, $2380-$2950; increase in cost, 41%) attributable costs per CDAD episode by linear regression and with $3240 attributable costs (P < .001; increase in cost, 33%) by propensity-score matched-pairs analysis. CDAD was associated with $5042 (95% confidence interval, $3797-$6481; increase in cost, 53%) attributable inpatient costs over 180 days by linear regression and with $7179 attributable costs for inpatient care (P < .001; 48% increase in costs) by propensity-score matched-pairs analysis.
  
  
  CONCLUSIONS
  CDAD was associated with a significant increase in costs for inpatient care and increased costs at 180 days after the initial hospitalization when the CDAD episode occurred.
authors.affiliation: Washington University School of Medicine, Saint Louis, Missouri, USA. edubberk@im.wustl.edu
authors.forename: Erik R
authors.initials: ER
authors.lastname: Dubberke
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Reske
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Olsen
authors.forename: L Clifford
authors.initials: LC
authors.lastname: McDonald
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Fraser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile / Q000302:isolation & purification*; D015331:Cohort Studies; D017281:Cost of Illness; D004761:Enterocolitis, Pseudomembranous / Q000191:economics* / Q000382:microbiology; D005260:Female; D017048:Health Care Costs; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri; D012189:Retrospective Studies