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Analysis

Multidrug-Resistant Infections Can Cost $4,600 Per Hospital Stay

By Christopher Cheney  
   April 04, 2019

Clostridium difficile infections in the hospital setting have the biggest treatment price tag, researchers say.

Infections linked to multidrug-resistant organisms (MDROs) cause a significant cost burden for U.S. healthcare, recent research shows.

The development of antibiotic-resistant infections is one of the most severe public health problems in the country, according to the Centers for Disease Control and Prevention. About 23,000 Americans die annually from an antibiotic-resistant infection, the CDC says.

The national price tag for treating infections linked to MDROs in the hospital setting is at least $2.39 billion, according to the recent research, which was published in the journal Health Services Research.

The researchers also tallied the treatment cost per inpatient hospital stay for methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. difficile), and other MDROs.

  • Treatment of infection with MRSA cost about $1,700
     
  • Infection with C. difficile cost about $4,600
     
  • Infection with another MDRO cost about $2,300
     
  • Infection with multiple MDROs cost about $3,500

"We find the highest incremental and total costs for C. difficile and the lowest incremental costs for MRSA, consistent with estimates from previous reports. The higher costs appear to be driven largely by a higher average length of stay, but may also be due to additional testing and increased risk for ICU admission with C. difficile," the researchers wrote.

In 2014, the President's Council of Advisors on Science and Technology made several recommendations to combat antibiotic resistance, including surveillance of MDROs in healthcare settings and the community, anti-microbial stewardship campaigns, precautions to limit exposure, and education of patients and physicians about the dangers of overprescribing antibiotics.

Calculating superbug economics
 

The lead author of the Health Services Research article, Kenton Johnston, PhD, MPH, told HealthLeaders that determining the cost effectiveness of efforts to reduce MDRO infections is challenging.

"Essentially, you are comparing the costs of MDRO-reduction efforts to the savings generated by those efforts. The costs of MDRO-reduction efforts would be the programmatic costs of interventions. This is tricky because the interventions are wide-ranging throughout society such as hand-washing campaigns. The savings part is also tricky because the savings also accrue throughout society," said Johnston, an assistant professor at the College for Public Health & Social Justice, St. Louis University.

Johnston's research team only examined hospital costs of efforts to combat MDRO infections.

"A systematic review of the literature on just the cost side of this equation found that the cost of measures to combat and eradicate MDROs ranges from $331 to $66,772 per MDRO-positive patient. This is obviously an unacceptably huge range for calculating the cost side of the equation alone. As a result, more research needs to be done," he said.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


KEY TAKEAWAYS

About 23,000 Americans die annually from antibiotic-resistant infections, according to the CDC.

The national cost for treating infections linked to multidrug-resistant organisms is at least $2.39 billion.

Efforts to combat multidrug-resistant organisms include anti-microbial stewardship campaigns.


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