The potential economic value of screening hospital admissions for Clostridium difficile

Sarah Bartsch, S. R. Curry, L. H. Harrison, Bruce Lee

Research output: Contribution to journalArticle

Abstract

Asymptomatic Clostridium difficile carriage has a prevalence reported as high as 51-85 %; with up to 84 % of incident hospital-acquired infections linked to carriers. Accurately identifying carriers may limit the spread of Clostridium difficile. Since new technology adoption depends heavily on its economic value, we developed an analytic simulation model to determine the cost-effectiveness screening hospital admissions for Clostridium difficile from the hospital and third party payer perspectives. Isolation precautions were applied to patients testing positive, preventing transmission. Sensitivity analyses varied Clostridium difficile colonization rate, infection probability among secondary cases, contact isolation compliance, and screening cost. Screening was cost-effective (i.e., incremental cost-effectiveness ratio [ICER] ≤$50,000/QALY) for every scenario tested; all ICER values were≤$256/QALY. Screening was economically dominant (i.e., saved costs and provided health benefits) with a ≥10.3 % colonization rate and ≥5.88 % infection probability when contact isolation compliance was ≥25 % (hospital perspective). Under some conditions screening led to cost savings per case averted (range, $53-272). Clostridium difficile screening, coupled with isolation precautions, may be a cost-effective intervention to hospitals and third party payers, based on prevalence. Limiting Clostridium difficile transmission can reduce the number of infections, thereby reducing its economic burden to the healthcare system.

Original languageEnglish (US)
Pages (from-to)3163-3171
Number of pages9
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Volume31
Issue number11
DOIs
StatePublished - Nov 2012
Externally publishedYes

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Clostridium difficile
Economics
Cost-Benefit Analysis
Health Insurance Reimbursement
Costs and Cost Analysis
Quality-Adjusted Life Years
Compliance
Infection
Cost Savings
Insurance Benefits
Cross Infection
Technology
Delivery of Health Care

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

The potential economic value of screening hospital admissions for Clostridium difficile. / Bartsch, Sarah; Curry, S. R.; Harrison, L. H.; Lee, Bruce.

In: European Journal of Clinical Microbiology and Infectious Diseases, Vol. 31, No. 11, 11.2012, p. 3163-3171.

Research output: Contribution to journalArticle

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