Clostridium difficile associated infection: view of hospital-based health technology assessment

Abstract

Aim. To evaluate the clinical and economic outcomes associated with cases of Clostridium difficile associated colitis from the standpoint of the Hospital and health care system researcher. Materials and methods. A retrospective case-control observational study was conducted, which included 900 patients (450 in the disease and control group) treated in St. Petersburg state medical institution “St. George Hospital” with an assessment of clinical and economic outcomes (probability of death and hospitalization in the ICU; prolongation of hospitalization, including in the ICU, the cost of the completed case of the disease according to the rates of statutory health insurance). Results. There are significant consequences associated with cases of the disease, both from a clinical and economic point of view: high risks of death (OR 1.52), risks of hospitalization in the ICU (OR 1.57); prolongation of General hospitalization (+8 days) and hospitalization in the ICU (+3 days), as well as significant incremental cost of hospitalization. At the same time, the losses of the State as a payer are significant and amount to about 25.5 thousand rubles for each case of colitis, while the direct costs of the hospital do not exceed 3 thousand rubles. Summary. Efforts to prevent episodes of Clostridium difficile associated colitis, as well as the development of new treatment regimens are important for reducing the burden of the disease, and the resulting calculations can provide useful information when conducting pharmacoeconomical analysis of new treatment regimens for the disease.