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Secondary UTI diagnosis increased clinical, economic burdens
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DENVER — Urinary tract infections are significantly associated with the utilization of health care resources among hospitalized patients, researchers reported here at the 2013 Interscience Conference on Antimicrobial Agents and Chemotherapy.
“UTI is one of the most prevalent admission diagnoses in hospital-based clinical practice,” Shawn MacVane, PharmD, and colleagues from the Center for Anti-Infective Research and Development at Hartford Hospital wrote. “Despite its frequency, few data are available regarding the demography and economic implications of these UTI-related admissions.”
The retrospective cohort study included 2,345 patients (mean age, 78 years; 71% female) admitted to Hartford Hospital with a UTI from September 2011 to August 2012.
Researchers found that 21% of participants had a primary diagnosis at discharge and 79% had a secondary diagnosis. The median length of hospital stay was 5 days with a median cost of
$8,326. Payment methods were primarily Medicare (68%), managed care (12%), Medicaid (10%) and private insurance (8%). Within 30 days of discharge, 15.3% of participants were readmitted to the hospital, 4.7% of whom had a UTI at the time of readmission. Men were more likely than women to be readmitted within 30 days (P=.002). Participants with a primary diagnosis were older (mean age, 87 years) compared with a secondary diagnosis (mean age, 77 years). Secondary diagnoses were associated with increased cost, longer length of stay, greater mortality and increased admission to the ICU. No differences were found between primary and secondary diagnosis for 30-day readmission rates (P=.557).
“We need to recognize the burden and prevalence of the disease and implications for treating it accordingly,” MacVane told Infectious Disease News. “It’s important to manage these patients appropriately and try to keep them out of the hospital because when they do get readmitted, the infections they get are more difficult to treat because of the antibiotics they received originally.”
For more information:
MacVane SH. Abstract L-739. Presented at: ICAAC 2013; Sept. 9-13, 2013; Denver.
Disclosure: MacVane reports no relevant financial disclosures.