title: A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida.
abstract: BACKGROUND
  Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated.
  
  
  RESULTS
  IDUs discharged from Jackson Memorial Hospital were identified using the International Classification of Diseases, Ninth Revision, codes for illicit drug abuse and endocarditis, bacteremia or sepsis, osteomyelitis and skin and soft tissue infections (SSTIs). 349 IDUs were identified for chart abstraction and 92% were either uninsured or had publicly funded insurance. SSTIs, the most common infection, were reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients (4.9%) died during their hospitalization. The total cost for treatment for injection drug use-related infections to Jackson Memorial Hospital over the 12-month period was $11.4 million.
  
  
  CONCLUSIONS
  Injection drug use-related bacterial infections represent a significant morbidity for IDUs in Miami-Dade County and a substantial financial cost to the county hospital. Strategies aimed at reducing risk of infections associated with injection drug use could decrease morbidity and the cost associated with these common, yet preventable infections.
authors.affiliation: Department of Internal Medicine, Jackson Memorial Hospital, Miami, Florida, United States of America.
authors.forename: Hansel
authors.initials: H
authors.lastname: Tookes
authors.affiliation: Department of Medical Education, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
authors.forename: Chanelle
authors.initials: C
authors.lastname: Diaz
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
authors.forename: Hua
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Jackson Health System Research, Jackson Memorial Hospital, Miami, Florida, United States of America.
authors.forename: Rafi
authors.initials: R
authors.lastname: Khalid
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
authors.forename: Susanne
authors.initials: S
authors.lastname: Doblecki-Lewis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D055030:Drug Users; D005260:Female; D005431:Florida; D006760:Hospitalization; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D064876:Safety-net Providers; D015819:Substance Abuse, Intravenous / Q000150:complications; D055815:Young Adult