title: Cost analysis of hospitalized Clostridium difficile-associated diarrhea (CDAD).
abstract: OBJECTIVE
  Clostridium difficile-associated diarrhea (CDAD) causes heavy financial burden on healthcare systems worldwide. As with all hospital-acquired infections, prolonged hospital stays are the main cost driver. Previous cost studies only include hospital billing data and compare the length of stay in contrast to non-infected patients. To date, a survey of actual cost has not yet been conducted.
  
  
  METHODS
  A retrospective analysis of data for patients with nosocomial CDAD was carried out over a 1-year period at the University Hospital of Greifswald. Based on identification of CDAD related treatment processes, cost of hygienic measures, antibiotics and laboratory as well as revenue losses due to bed blockage and increased length of stay were calculated.
  
  
  RESULTS
  19 patients were included in the analysis. On average, a CDAD patient causes additional costs of € 5,262.96. Revenue losses due to extended length of stay take the highest proportion with € 2,555.59 per case, followed by loss in revenue due to bed blockage during isolation with € 2,413.08 per case. Overall, these opportunity costs accounted for 94.41% of total costs. In contrast, costs for hygienic measures (€ 253.98), pharmaceuticals (€ 22.88) and laboratory (€ 17.44) are quite low.
  
  
  CONCLUSIONS
  CDAD results in significant additional costs for the hospital. This survey of actual costs confirms previous study results.
authors.affiliation: Department of Health Care Management, University of Greifswald, Greifswald, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Hübner
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Nils-Olaf
authors.initials: NO
authors.lastname: Hübner
authors.affiliation: Department of Health Care Management, University of Greifswald, Greifswald, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Muhr
authors.affiliation: Department of Economics and Financial Management, University of Greifswald, Greifswald, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Claus
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Leesch
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
authors.affiliation: Department of Health Care Management, University of Greifswald, Greifswald, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Flessa
keywords: Clostridium difficile; extension of length of stay; nosocomial infections; opportunity costs