Clostridium difficile is the leading bacterial cause healthcare-associated diarrhea. CDI has been targeted by CMS and private payers for reduction under various payment incentive programs. Previous studies have focused on disease incidence in the general population, and excluded maternal discharges. The goal of this study was to examine the disease burden in the low risk MAHD population.
Data included discharge records of all hospitalized patients in the Healthcare Costs and Utilization Project - Nationwide Inpatient Sample (HCUP-NIS) from 2001 to 2012. Maternal discharges were identified by major diagnostic category (MDC) code of 14 then ICD-9 CM codes were used to identify CDI (008.45). Charges were converted to costs using the HCUP Cost-to-Charge ratio files and adjusted for inflation. Unadjusted and multi-variate adjusted LOS and costs were estimated.
MAHD patients with CDI were sicker in terms of number of diagnoses and Charlson Comorbidity Index (p=0.0004) compared to those without CDI. There were no significant differences in terms of age, race, region, or having insurance. The largest two payers for the MAHD patients with CDI were Medicaid (45.88%) and private including HMO (48.45%). There was a significant 1.66-fold increase of CDI among MAHD, from 1.44 in 2001 to 2.39 in 2012 per 10,000 discharges (p=0.0001). There were no significant differences in LOS or cost for maternal CDI, due to the low number of cases and wide variation over the time period. Both unadjusted and adjusted values showed the same trend.
The CDI prevalence rate has increased significantly for this otherwise low risk population.
Q. Shi, None
M. Schoonmaker, None
L. Shi, None
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