Open Access1427. Healthcare Resource Utilization During Hospitalizations with UTI in the US, 2018
Author(s) -
Marya D. Zilberberg,
Brian H. Nathanson,
Kate Sulham
Publication year - 2021
Publication title -
open forum infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.546
H-Index - 35
ISSN - 2328-8957
DOI - 10.1093/ofid/ofab466.1619
Subject(s) - medicine , interquartile range , health care , emergency medicine , healthcare cost and utilization project , diagnosis code , pediatrics , environmental health , population , economics , economic growth
Background Urinary tract infection (UTI) as the reason for hospitalization costs the US healthcare system nearly &3 billion annually, and is on the rise. We set out to explore the full burden of UTI hospitalizations in the US, including admissions both for UTI and with UTI. Methods We conducted a cross-sectional multicenter study within the National Inpatient Sample (NIS) database, a 20% stratified sample of discharges from US hospitals, from 2018, to explore hospital resource utilization of patients discharged with a UTI diagnosis. We divided UTI into mutually exclusive categories of complicated (cUTI), uncomplicated (uUTI), and catheter-associated (CAUTI), in addition to healthcare-associated (HAUTI). We calculated unadjusted hospital charges, costs, average reimbursements, and length of stay (LOS) associated with these infections.Results Among 2,837,385 discharges with a UTI code, 77.9% were uUTI, 17.6% cUTI (80.2% HAUTI), and 4.4% CAUTI; UTI was principal diagnosis in only 17.0%. Median [interquartile range, IQR] LOS ranged from 4 [3-8] days in uUTI and cUTI to 5 [3-9] days in CAUTI. Overall median [IQR] hospital charges and costs were lowest in uUTI (&36,335 [&19,920-&70,745] and &8,898 [&5,408-&16,092], respectively) and highest in cUTI (&39,690 [&21,997-&75,739] and &9,713 [&5,923-&17,423], respectively), with the HAUTI subgroup being most costly (&44,650 [&24,642-&85,628] and &10,945 [&6,573-&19,634], respectively). “Septicemia or Severe Sepsis without MV >96 Hours with MCC” was the most common DRG in uUTI (13.2%) and cUTI (14.2%), with the corresponding median [IQR] reimbursements of &11,057 [&7,028-&17,757] and &12,226 [&7,889-&19,216], respectively. In contrast, CAUTI was most commonly (44.7%) reimbursed under “Kidney and Urinary Tract Infections without MCC” at &8,635 [&5,693-&13,718].Conclusion The nearly 3 million hospital admissions with a UTI represent 8% of all annual admissions in the US. Though the majority are considered uncomplicated, all categories are nearly equally costly. Given that over 80% of all UTI-associated admissions are with UTI as a secondary diagnosis, annual estimates of primary UTI costs likely significantly underrepresent the true economic burden of UTI on the US healthcare system.Disclosures Marya Zilberberg, MD, MPH , Cleveland Clinic (Consultant) J&J (Shareholder) Lungpacer (Consultant, Grant/Research Support) Merck (Grant/Research Support) scPharma (Consultant) Sedana (Consultant, Grant/Research Support) Spero (Grant/Research Support) Brian Nathanson, PhD , Lungpacer (Grant/Research Support) Merck (Grant/Research Support) Spero (Grant/Research Support) Kate Sulham, MPH , Spero Therapeutics (Consultant)