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Contact: Joe Martin
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Harrisburg, PA – March 1, 2018 – The Pennsylvania Health Care Cost Containment Council (PHC4) released a new research brief today on Clostridium difficile infections—a common infection, often referred to as C. diff or CDI, that can cause severe suffering and can be life threatening. These infections are characterized by watery diarrhea, fever, loss of appetite and abdominal discomfort. Prolonged use of antibiotics, particularly in the elderly as well as those individuals with other illnesses, poses an elevated risk for contracting a CDI.

PHC4’s research found that hospitalized patients with a CDI often have higher in-hospital mortality and readmission rates and tend to stay in the hospital longer. Hospital payments also tend to be higher for patients with a CDI. For patients hospitalized for congestive heart failure, patients with a CDI had in-hospital mortality rates that were double those for patients who did not have a CDI (5.6% compared to 2.8%), and they typically stayed in the hospital longer (7 days versus 4 days). Readmission rates for patients with a CDI were 39% higher (33.6% versus 24.2%). Estimated hospital payments averaged $13,711 compared to $9,380. The research brief also examines the impact these infections have on other common conditions such as sepsis, pneumonia and diabetes.

The good news is that, while still relatively high, in-hospital mortality and readmission rates for CDI patients have decreased in the last ten years. In-hospital mortality dropped 42% (from 9.7% to 5.7%) and readmission rates dropped 14%, from 32.9% to 28.2%. Average length of stay for CDI patients dropped from 8 days to 6 days.

“Releasing this brief helps raise awareness about how these infections affect Pennsylvania residents and highlights the burden they place on the health care system,” said Joe Martin, PHC4’s Executive Director. “We also observed some interesting findings with regard to CDI and its relationship to sepsis, so the increases we are seeing in sepsis cases might have a negative ripple effect in the future with regard to the number of CDI cases,” added Martin.

In FY 2017, there were 17,495 hospital admissions for patients with a CDI—a number that has been relatively steady since FY 2008. Of the 17,495 CDI hospital admissions, about 30% of patients were hospitalized specifically for the infection. About 50% were admitted to the hospital for another condition but also had a CDI when they were admitted. The remaining 20% were admitted for another condition but developed a CDI after being admitted to the hospital. Patients who developed a CDI while in the hospital had higher mortality rates (8.5%) and stayed in the hospital longer (average of 13 days) than patients who had the infection when they were admitted (5.0% mortality rate with an average length of stay of 5 days).

The brief also examines population-based rates. Statewide, there were 13 CDI hospitalizations per 10,000 Pennsylvania residents in FY 2017. The rate for those aged 65 and older was much higher at 46.3 per 10,000 residents.

County-level population-based rates are also included in the brief.

The brief is available on PHC4’s website at You can also link to it through social media on Facebook and Twitter.

PHC4 is an independent state agency charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care in Pennsylvania.

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Phone: (717) 232-6787
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