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1691. Pre- and Post-Hospitalization Resource Utilization and Costs Associated with Urinary Tract Infection (UTI) in both Commercial and Medicare Populations
BACKGROUND: In the United States, urinary tract infections (UTIs) result in an estimated 7 million office visits, 1 million emergency department visits, and over 500,000 hospitalizations with an associated annual cost of $1.6 billion. Little is known regarding pre- and post-hospitalization resource...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777860/ http://dx.doi.org/10.1093/ofid/ofaa439.1869 |
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author | Melnick, David Baljian, Nayiri Jain, Akash Sulham, Katherine |
author_facet | Melnick, David Baljian, Nayiri Jain, Akash Sulham, Katherine |
author_sort | Melnick, David |
collection | PubMed |
description | BACKGROUND: In the United States, urinary tract infections (UTIs) result in an estimated 7 million office visits, 1 million emergency department visits, and over 500,000 hospitalizations with an associated annual cost of $1.6 billion. Little is known regarding pre- and post-hospitalization resource use. Here, we quantify resource utilization and costs associated with both commercially insured and Medicare patients hospitalized for UTI. METHODS: A retrospective multi-center study using data from the MarketScan® Commercial and Medicare Supplemental Databases was performed. Inclusion criteria: (1) inpatient hospital admission with a primary ICD-10 diagnosis for UTI between October 1, 2015 and December 31, 2017 (index hospitalization), (2) at least 6 months of continuous enrollment and pharmacy benefits prior to the index date, (3) at least 12 months of continuous enrollment and pharmacy benefits after the index date, (4) patient age < 64 (Commercial) or ≥65 (Medicare) on the index date. Demographics, hospitalization characteristics, antibiotic use, and resource utilization/costs in the pre- and post-index periods were examined. RESULTS: 5,248 Commercial and 7,791 Medicare patients were eligible for analysis. 29.7% and 24.1% of Medicare and Commercial patients, respectively, were male. 5.9% of Medicare patients had a claim for skilled nursing facilities (SNF) in the 14 days pre-index admission (1.0% Commercial), 9.1% had emergency department claims (13.1% Commercial), and 39.8% had office visit claims (49.9% Commercial). Post-hospitalization, 20.3% (1.3% Commercial) were discharged to SNF and 15.4% (4.7%) were discharged to home health services. Mean insurer UTI-related costs were $8,677 (Commercial) and $5,358 (Medicare) in the 6 months pre-index hospitalization. Similarly, costs were $21,135 (Commercial) and $22,342 (Medicare) in the 12 months post hospitalization ($3,944 and $2,988 in the first 30 days post-discharge, respectively). CONCLUSION: UTI is associated with substantial costs and resource utilization to insurers in both pre- and post-hospitalization settings. Understanding total costs of care and location of service may aid in cost-reduction strategies for treating UTI. DISCLOSURES: David Melnick, MD, Spero Therapeutics (Employee)Spero Therapeutics (Employee) Nayiri Baljian, n/a, Spero Therapeutics (Employee) Akash Jain, PhD, Spero Therapeutics (Employee) Katherine Sulham, MPH, Spero Therapeutics (Independent Contractor) |
format | Online Article Text |
id | pubmed-7777860 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-77778602021-01-07 1691. Pre- and Post-Hospitalization Resource Utilization and Costs Associated with Urinary Tract Infection (UTI) in both Commercial and Medicare Populations Melnick, David Baljian, Nayiri Jain, Akash Sulham, Katherine Open Forum Infect Dis Poster Abstracts BACKGROUND: In the United States, urinary tract infections (UTIs) result in an estimated 7 million office visits, 1 million emergency department visits, and over 500,000 hospitalizations with an associated annual cost of $1.6 billion. Little is known regarding pre- and post-hospitalization resource use. Here, we quantify resource utilization and costs associated with both commercially insured and Medicare patients hospitalized for UTI. METHODS: A retrospective multi-center study using data from the MarketScan® Commercial and Medicare Supplemental Databases was performed. Inclusion criteria: (1) inpatient hospital admission with a primary ICD-10 diagnosis for UTI between October 1, 2015 and December 31, 2017 (index hospitalization), (2) at least 6 months of continuous enrollment and pharmacy benefits prior to the index date, (3) at least 12 months of continuous enrollment and pharmacy benefits after the index date, (4) patient age < 64 (Commercial) or ≥65 (Medicare) on the index date. Demographics, hospitalization characteristics, antibiotic use, and resource utilization/costs in the pre- and post-index periods were examined. RESULTS: 5,248 Commercial and 7,791 Medicare patients were eligible for analysis. 29.7% and 24.1% of Medicare and Commercial patients, respectively, were male. 5.9% of Medicare patients had a claim for skilled nursing facilities (SNF) in the 14 days pre-index admission (1.0% Commercial), 9.1% had emergency department claims (13.1% Commercial), and 39.8% had office visit claims (49.9% Commercial). Post-hospitalization, 20.3% (1.3% Commercial) were discharged to SNF and 15.4% (4.7%) were discharged to home health services. Mean insurer UTI-related costs were $8,677 (Commercial) and $5,358 (Medicare) in the 6 months pre-index hospitalization. Similarly, costs were $21,135 (Commercial) and $22,342 (Medicare) in the 12 months post hospitalization ($3,944 and $2,988 in the first 30 days post-discharge, respectively). CONCLUSION: UTI is associated with substantial costs and resource utilization to insurers in both pre- and post-hospitalization settings. Understanding total costs of care and location of service may aid in cost-reduction strategies for treating UTI. DISCLOSURES: David Melnick, MD, Spero Therapeutics (Employee)Spero Therapeutics (Employee) Nayiri Baljian, n/a, Spero Therapeutics (Employee) Akash Jain, PhD, Spero Therapeutics (Employee) Katherine Sulham, MPH, Spero Therapeutics (Independent Contractor) Oxford University Press 2020-12-31 /pmc/articles/PMC7777860/ http://dx.doi.org/10.1093/ofid/ofaa439.1869 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Poster Abstracts Melnick, David Baljian, Nayiri Jain, Akash Sulham, Katherine 1691. Pre- and Post-Hospitalization Resource Utilization and Costs Associated with Urinary Tract Infection (UTI) in both Commercial and Medicare Populations |
title | 1691. Pre- and Post-Hospitalization Resource Utilization and Costs Associated with Urinary Tract Infection (UTI) in both Commercial and Medicare Populations |
title_full | 1691. Pre- and Post-Hospitalization Resource Utilization and Costs Associated with Urinary Tract Infection (UTI) in both Commercial and Medicare Populations |
title_fullStr | 1691. Pre- and Post-Hospitalization Resource Utilization and Costs Associated with Urinary Tract Infection (UTI) in both Commercial and Medicare Populations |
title_full_unstemmed | 1691. Pre- and Post-Hospitalization Resource Utilization and Costs Associated with Urinary Tract Infection (UTI) in both Commercial and Medicare Populations |
title_short | 1691. Pre- and Post-Hospitalization Resource Utilization and Costs Associated with Urinary Tract Infection (UTI) in both Commercial and Medicare Populations |
title_sort | 1691. pre- and post-hospitalization resource utilization and costs associated with urinary tract infection (uti) in both commercial and medicare populations |
topic | Poster Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777860/ http://dx.doi.org/10.1093/ofid/ofaa439.1869 |
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