SHM Converge Scientific Abstract ePoster Gallery-Clostridioides Difficile: A Recurrent Infection With Broad Economic Consequences

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This poster examined the economic burden of recurrent Clostridioides difficile infection (CDI) on US hospitals using the Premier Healthcare Database. In a retrospective analysis of 108,329 patients hospitalized with an index CDI event between January 2017 and September 2018, patients were followed for up to 12 months to assess rehospitalizations, mortality, hospital costs, and expected Medicare reimbursement.<br /><br />The study found substantial clinical and financial burden. Within 12 months, 42% of patients had at least one rehospitalization, and many of these readmissions were CDI-related. Inpatient mortality was notable at the index hospitalization and remained high during subsequent CDI-related rehospitalizations, with about 8% of patients dying during a CDI-related inpatient stay over the follow-up period.<br /><br />Average hospital cost per admission was $21,004, while average expected reimbursement was lower, creating a provider revenue loss of about $4,288 per admission. Costs generally exceeded reimbursement across the most common Medicare Severity Diagnosis-Related Groups (MS-DRGs), and ICU admissions were especially costly. Financial deficits accumulated with each recurrent hospitalization.<br /><br />A sample hospital with 94 CDI admissions per year was estimated to have 46 survivors after the first CDI recurrence, with a typical annual financial loss of $10,986 per survivor of first rehospitalization. The model projected 2.3 avoided admissions, 2 fewer ICU days, and 16 fewer hospital days if first recurrence were fully prevented, translating into about $54,568 in avoided costs but also highlighting lost reimbursement and overall financial losses.<br /><br />The analysis also suggested that hospitals could face an additional 1% to 4% Medicare penalty tied to CDI performance measures, potentially adding $1.4 million to $5.5 million in losses for a hospital with $137 million in Medicare fee-for-service reimbursement. Overall, the study concluded that recurrent CDI has broad and compounding economic consequences for US hospitals, and interventions that reduce readmissions could deliver major clinical and financial benefits.

Asset Subtitle

Beth Guthmueller

Meta Tag

Author List Amy Guo, Beth Guthmueller, Chris Poole, Glenn Tillotson, Samson Ng

Category Research

Concept Clostridioides difficile Infection

Concept Recurrent Clostridioides difficile infection

Concept Hospitalization

Concept Hospitalization Cost

Concept US hospital

Distinguished Non-Finalist

Presenter Organization Rebiotix Inc.

Presenting Author Beth Guthmueller

Track Value in Hospital Medicine

Keywords

Clostridioides difficile infection

recurrent CDI

hospital readmissions

economic burden

hospital costs

Medicare reimbursement

Premier Healthcare Database

inpatient mortality

ICU admissions

MS-DRG

Clostridioides difficile Infection

Recurrent Clostridioides difficile infection

Hospitalization

Hospitalization Cost

US hospital