Methods: This is a retrospective study of CDI patients with & without rCDI from Jun 2011 through Sep 2014 using Truven Health MarketScan® Commercial & Medicare Supplemental Databases. A cohort of CDI patients were followed for 6 months following an index episode covering all health care utilization, costs & subsequent recurrences. Two sub-cohorts were defined: a sub-cohort without rCDI & a sub-cohort with rCDI. rCDI was defined as a CDI episode 15-84 days following the index episode. We estimated the incremental cost of recurrence over & above that associated with having only a single episode. Propensity score matching was used to match CDI patients with & without rCDI on a 1:1 basis. The rCDI patients had the time marked from the diagnosis date of the index CDI to the diagnosis date of the recurrent episode. This time was added to discharge date of the single CDI patient. Follow-up of the matched pair started from this point onwards for 6 months
Results: A total of 12,025 CDI patients were identified (N=8,906 without rCDI; N=2,994 with rCDI). Patients were mainly female (63%) & the average age was 59 years old. Healthcare utilization & costs were significantly higher among CDI patients with rCDI compared with those without rCDI after controlling for baseline differences through matching. The total mean all- cause healthcare expenditures were $35,025 (SD: $76,637) & $19,959 (SD:$55,332), respectively, for patients with & without rCDI. The difference of the means was $21,912.15 (p-value < 0.001). C. diff-related costs were also higher among patients with rCDI with expenditures of $10,287 (SD: $30,730) & $5,169 (SD: $13,277), respectively for those with & without recurrence.
Conclusion: CDI patients with recurrences had higher healthcare utilization & expenditures compared to those without recurrences. Prevention of rCDI may reduce the economic burden that CDI management poses on the US healthcare system.
Merck Sharp & Dhome:
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