1427. Healthcare Resource Utilization During Hospitalizations with UTI in the US, 2018. (4th December 2021)

• Record Type: Journal Article
• Authors: Zilberberg, Marya; Nathanson, Brian; Sulham, Kate
• Is Part Of: Open forum infectious diseases. Volume 8(2021)Supplement 1
• Page Start: S796
• Page End: S796
• Publication Date: 2021-12-04
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofab466.1619
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: 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)