PMID- 30190105
OWN - NLM
STAT- MEDLINE
DCOM- 20190111
LR  - 20220409
IS  - 1437-7780 (Electronic)
IS  - 1341-321X (Linking)
VI  - 24
IP  - 11
DP  - 2018 Nov
TI  - Healthcare burden of recurrent Clostridioides difficile infection in Japan: A 
      retrospective database study.
PG  - 892-901
LID - S1341-321X(18)30241-1 [pii]
LID - 10.1016/j.jiac.2018.07.020 [doi]
AB  - This retrospective database study aimed to assess the healthcare burden of 
      hospitalization cost and duration associated with recurrent Clostridioides 
      difficile infection (rCDI) by comparison with C. difficile infection (CDI) in 
      Japan, using a health claims database of 270 acute care hospitals. Overall, 5423 
      hospitalized patients, with a record of one hospital-onset, healthcare 
      facility-associated primary CDI episode within the 180-day period, from its onset 
      between January 2012 and September 2016, were included. Of these, 353 had at 
      least one rCDI and 5070 had no rCDI. Compared with those with no rCDI, the median 
      total cost of hospitalization for patients with rCDI was JPY 1,184,371 (USD 
      11,691) higher (JPY 2,489,424 [interquartile range IQR: 1,597,424-4,008,751] 
      compared with JPY 1,305,053 [624,033-2,549,569]). In addition, rCDI resulted in 
      twice longer hospitalization duration in median compared with CDI (79 days [IQR: 
      53-117] compared with 40 days [20-74]). Based on a generalized linear regression 
      model with a Gamma distribution and a logarithmic link function, the estimated 
      mean of cost and duration of hospitalization for patients with rCDI were JPY 
      1,284,519 (95% confidence limit: -95,532-2,664,569) (USD 12,679) higher and 20.3 
      days (-9.5‒50.0) longer, compared with patients with no rCDI. The estimated mean 
      difference in cost was higher in older patients and patients with diseases 
      resulting in an immunosuppressive state. Higher costs and longer hospitalization 
      for rCDI impose a great burden on healthcare system as well as patients, 
      highlighting the importance of preventing recurrence of CDI.
CI  - Copyright (c) 2018 Japanese Society of Chemotherapy and The Japanese Association 
      for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
FAU - Kunishima, Hiroyuki
AU  - Kunishima H
AD  - Department of Infectious Diseases, St. Marianna University, 2-16-1 Sugao, 
      Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
FAU - Ito, Kaoru
AU  - Ito K
AD  - Outcomes Research, Market Access, MSD K.K., Kitanomaru Square, 1-13-12 
      Kudan-kita, Chiyoda-ku, Tokyo 102-8667, Japan. Electronic address: 
      kaoru.ito@merck.com.
FAU - Laurent, Thomas
AU  - Laurent T
AD  - Clinical Study Support, Inc., Daiei Bldg., 2F, 1-11-20 Nishiki, Naka-ku, Nagoya, 
      Aichi 460-0003, Japan.
FAU - Abe, Machiko
AU  - Abe M
AD  - Outcomes Research, Market Access, MSD K.K., Kitanomaru Square, 1-13-12 
      Kudan-kita, Chiyoda-ku, Tokyo 102-8667, Japan.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20180903
PL  - Netherlands
TA  - J Infect Chemother
JT  - Journal of infection and chemotherapy : official journal of the Japan Society of 
      Chemotherapy
JID - 9608375
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
EIN - J Infect Chemother. 2020 Jan;26(1):148. PMID: 31744766
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Anti-Bacterial Agents/economics/therapeutic use
MH  - Clostridioides difficile/drug effects/*isolation & purification
MH  - Clostridium Infections/drug therapy/*economics/epidemiology/microbiology
MH  - *Cost of Illness
MH  - Cross Infection/drug therapy/*economics/epidemiology/microbiology
MH  - Female
MH  - Health Care Costs/*statistics & numerical data
MH  - Health Information Systems/statistics & numerical data
MH  - Hospitalization/*economics/statistics & numerical data
MH  - Humans
MH  - Japan/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Secondary Prevention/methods
MH  - Time Factors
MH  - Young Adult
OTO - NOTNLM
OT  - Clostridioides difficile infection
OT  - Hospitalization
OT  - Length of stay
OT  - Medical cost
OT  - Recurrence
EDAT- 2018/09/08 06:00
MHDA- 2019/01/12 06:00
CRDT- 2018/09/08 06:00
PHST- 2018/04/23 00:00 [received]
PHST- 2018/07/02 00:00 [revised]
PHST- 2018/07/31 00:00 [accepted]
PHST- 2018/09/08 06:00 [pubmed]
PHST- 2019/01/12 06:00 [medline]
PHST- 2018/09/08 06:00 [entrez]
AID - S1341-321X(18)30241-1 [pii]
AID - 10.1016/j.jiac.2018.07.020 [doi]
PST - ppublish
SO  - J Infect Chemother. 2018 Nov;24(11):892-901. doi: 10.1016/j.jiac.2018.07.020. 
      Epub 2018 Sep 3.