496. Economic Impacts of Hospital-associated Acute Respiratory Tract Infections
Session: Poster Abstract Session: Public Health
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • IDWeek 2013_poster.pdf (356.4 kB)
  • Background:

    Over decades, infection control strategies significantly impact disease transmission in healthcare settings. Data on the economic burden of hospital-associated acute respiratory tract infections (ARIs) caused by influenza and Respiratory Syncytial Virus (RSV) are limited. Because no recent studies have compared clinical or economic outcomes of patients with and without viral hospital-associated (HA) ARIs, we elected to examine the question.

    Methods:

    We conducted a nested case-control study of patients with laboratory-confirmed hospital-associated ARIs and matched controls in the Johns Hopkins Hospital between 1/2007 and 6/2012. All patients with HA influenza A, B and RSV were matched to 2 randomly selected controls who were hospitalized within the same time period. Cases and controls were matched for age, severity of illness, hospital services and critical care stay before the event. 

    Results:

    Among 2,799 laboratory-confirmed viral ARIs identified, 84 cases (3.00%) were HA, 9 cases were excluded because they had been readmitted. We analyzed 73 cases with influenza A (n=41; 56.2%); influenza B (n=8; 10.9%) and RSV (n=24; 32.9%).  Mean time to develop an ARI was 19.3 days (SD 24.9). Mortality (Hazard ratio 2.96, 95% CI 0.72-12.08, p=0.17), hospital stay after ARI (Hazard ratio 1.23, 95% CI 0.84-1.80, p=0.28), and critical care stays after ARI (Hazard ratio 0.97, 95% CI 0.44-2.14, p=0.95) did not differ between the two groups. We found that costs of those with HA influenza A was 1.8 (95% CI: 1.2-2.6, p=0.002) times higher than the costs of other patients, adjusting for age and use of contact precautions. Extra costs were driven by costs for therapy (2.5 times, 95% CI 1.4-4.6, p=0.003), lab (2.2 times, 95% CI 1.5-3.3, p<0.001), and pharmacy (1.7 times, 95% CI 1.1-2.6, p=0.02). 

    Conclusion:

    We found that the financial costs of HA viral ARIs is considerable, particularly for influenza A infections despite our relatively small sample and it involved a single center. Subsequent larger studies may further refine the financial impact and opportunities to prevent transmission of ARIs in healthcare settings.

    Pasri Maharom, MD, Johns Hopkins University School of Public Health, Baltimore, MD; Naval Medical Department, Bangkok, Thailand, Justin Lessler, PhD, Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD and Trish M. Perl, MD, MSc, FIDSA, FSHEA, Medicine, Johns Hopkins Medical Institutions, Baltimore, MD

    Disclosures:

    P. Maharom, None

    J. Lessler, None

    T. M. Perl, CDC: Investigator, Grant recipient

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