Attributable costs and length of stay of hospital-acquired Clostridioides difficile: A population-based matched cohort study in Alberta, Canada

2019 ◽  
Vol 40 (10) ◽  
pp. 1135-1143 ◽  
Author(s):  
Jenine R. Leal ◽  
John Conly ◽  
Robert Weaver ◽  
James Wick ◽  
Elizabeth A. Henderson ◽  
...  
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Propensity Score ◽  
Length Of Hospital Stay ◽  
Population Based ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Clostridioides Difficile ◽  
Hospital Acquired ◽  
Incident Cases

AbstractObjective:To determine the attributable cost and length of stay of hospital-acquired Clostridioides difficile infection (HA-CDI) from the healthcare payer perspective using linked clinical, administrative, and microcosting data.Design:A retrospective, population-based, propensity-score–matched cohort study.Setting:Acute-care facilities in Alberta, Canada.Patients:Admitted adult (≥18 years) patients with incident HA-CDI and without CDI between April 1, 2012, and March 31, 2016.Methods:Incident cases of HA-CDI were identified using a clinical surveillance definition. Cases were matched to noncases of CDI (those without a positive C. difficile test or without clinical CDI) on propensity score and exposure time. The outcomes were attributable costs and length of stay of the hospitalization where the CDI was identified. Costs were expressed in 2018 Canadian dollars.Results:Of the 2,916 HA-CDI cases at facilities with microcosting data available, 98.4% were matched to 13,024 noncases of CDI. The total adjusted cost among HA-CDI cases was 27% greater than noncases of CDI (ratio, 1.27; 95% confidence interval [CI], 1.21–1.33). The mean attributable cost was $18,386 (CAD 2018; USD $14,190; 95% CI, $14,312–$22,460; USD $11,046-$17,334). The adjusted length of stay among HA-CDI cases was 13% greater than for noncases of CDI (ratio, 1.13; 95% CI, 1.07–1.19), which corresponds to an extra 5.6 days (95% CI, 3.10–8.06) in length of hospital stay per HA-CDI case.Conclusions:In this population-based, propensity score matched analysis using microcosting data, HA-CDI was associated with substantial attributable cost.

scholarly journals Variant-of-concern-attributable health and health system-related outcomes: a population-level propensity-score matched cohort study

2021 ◽  
Author(s):  
Aysegul Erman ◽  
Sharmistha Mishra ◽  
Kali Barrett ◽  
Stephen Mac ◽  
David MJ Naimark ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Health Systems ◽  
Wild Type Strain ◽  
Severe Disease ◽  
Population Level ◽  
Population Based ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Incident Laboratory

Background: As the transmission of SARS-CoV-2 variants intensifies globally, the burden of COVID-19 on the already strained health systems is becoming increasingly concerning. While there is growing literature on the effects of various variants-of-concern (VOC) on increased transmission, the extent to which VOCs may lead to more severe disease remains debated. Methods: In the current analysis, we use a population-based propensity-score matched cohort study of all incident laboratory-confirmed COVID-19 cases with VOC testing in Ontario, Canada to estimate healthcare resource use and health outcomes attributable to VOCs introduced to Ontario between January 1 and April 9, 2021, relative to the previously circulating wild-type strain. Results: We find that VOCs are associated with a higher odds of hospitalisation (odds ratio [OR], 2.25; 95% confidence interval [CI], 2.10-2.40) and ICU admission (OR, 3.31; 95%CI, 2.84-3.86); as well as with a higher odds of mortality for both the general COVID-19 population (OR 1.75; 1.47-2.09) and hospitalised cases (OR, 1.62; 95%CI, 1.23-2.15). Conclusion: Taken together, these findings suggest that health systems may face increased demand for healthcare resources as VOCs predominate worldwide in view of low global vaccination coverage.

scholarly journals Mortality Risk Associated with Haloperidol Use Compared with Other Antipsychotics: An 11-Year Population-Based Propensity-Score-Matched Cohort Study

CNS Drugs ◽  
2020 ◽  
Vol 34 (2) ◽  
pp. 197-206 ◽  
Author(s):  
Kim S. J. Lao ◽  
Angel Y. S. Wong ◽  
Ian C. K. Wong ◽  
Frank M. C. Besag ◽  
W. C. Chang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Mortality Risk ◽  
Population Based ◽  
Matched Cohort ◽  
Matched Cohort Study

scholarly journals Perinatal Mental Illness and Risk of Incident Autoimmune Disease: A Population-Based Propensity-Score Matched Cohort Study

2021 ◽  
Vol Volume 13 ◽  
pp. 1119-1128
Author(s):  
Hilary K Brown ◽  
Andrew Wilton ◽  
Ning Liu ◽  
Joel G Ray ◽  
Cindy-Lee Dennis ◽  
...  
Keyword(s):  
Mental Illness ◽  
Cohort Study ◽  
Autoimmune Disease ◽  
Propensity Score ◽  
Population Based ◽  
Matched Cohort ◽  
Matched Cohort Study

scholarly journals Risk of reinfection after seroconversion to SARS-CoV-2: A population-based propensity-score matched cohort study

2021 ◽  
Author(s):  
Antonio Leidi ◽  
Flora Koegler ◽  
Roxane Dumont ◽  
Richard Dubos ◽  
Maria-Eugenia Zaballa ◽  
...  
Keyword(s):  
Cohort Study ◽  
Propensity Score ◽  
Smoking Status ◽  
Large Population ◽  
Population Based ◽  
Matched Cohort ◽  
Igg Antibodies ◽  
Matched Cohort Study ◽  
Pandemic Wave

Importance: Serological assays detecting specific IgG antibodies generated against the Spike protein following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection are being widely deployed in research studies and clinical practice. However, the duration and the effectiveness of the protection conferred by the immune response against future infection remains to be assessed in a large population. Objective: To estimate the incidence of newly acquired SARS-CoV-2 infections in seropositive individuals from a population-based sample as compared to seronegative controls. Design: Retrospective longitudinal propensity-score matched cohort study. Setting: A seroprevalence survey including a population-based representative sample of the population from the canton of Geneva (Switzerland) was conducted between April and June 2020, immediately after the first pandemic wave. Each individual included in the seroprevalence survey was linked to a state centralized registry compiling virologically confirmed SARS-CoV-2 infections since the beginning of the pandemic. Participants: Participants aged twelve years old and over, who developed anti-spike IgG antibodies were matched one-to-two to seronegative controls, using a propensity-score including age, gender, immunodeficiency, body mass index, smoking status and education level. Exposure: SARS-CoV-2 seropositivity. Main outcomes and measures: Our primary outcome was virologically confirmed SARS-CoV-2 infections which occurred from serological status assessment in April-June 2020 to the end of the second pandemic wave (January 2021). Additionally, incidence of infections, rate of testing and proportion of positive tests were analysed. Results: Among 8344 serosurvey participants, 498 seropositive individuals were selected and matched with 996 seronegative controls. After a mean follow-up of 35.6 (Standard Deviation, SD: 3.2) weeks, 7 out of 498 (1.4%) seropositive subjects had a positive SARS-CoV-2 test, of which 5 (1.0%) were considered as reinfections. By contrast, infection rate was significantly higher in seronegative individuals (15.5%, 154/996) during a similar mean follow-up of 34.7 (SD 3.2) weeks, corresponding to a 94% (95%CI 86% to 98%, P<0.001) reduction in the hazard of having a positive SARS-CoV-2 test for seropositive subjects. Conclusions and relevance: Seroconversion after SARS-CoV-2 infection confers protection to successive viral contamination lasting at least 8 months. These findings could help global health authorities establishing priority for vaccine allocation.

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