• epidemiology;
  • gastroenterology;
  • infections;
  • prevention and chemoprevention


Background and Aim

To investigate the impact of hospital-acquired Clostridium difficile infection (CDI) on hospital costs and patient length of stay.


Data from the 2007–2008 New York State Department of Health's Statewide Planning and Research Cooperative System (SPARCS) database was analyzed using regression analysis and descriptive statistics.


After analysis of 4 853 800 patient discharges, the incidence rate of hospital-acquired CDI was 0.8 cases per 1000 discharges. The estimated marginal cost associated with each hospital infection was approximately $29 000. The estimated annual cost of CDI in New York State was approximately $55 million with nearly 23 000 additional hospital days.


The development of hospital-acquired CDI is associated with a significant increase in hospital costs and patient length of stay. Extrapolation of these estimates to all US hospitals suggests this condition represents a major burden to the US healthcare system. Our findings may help hospitals understand the impact of these infections, as well as potential implications if deemed preventable by Centers for Medicare & Medicaid Services and/or private payers. Additionally, this information may benefit hospitals or health care systems transitioning to alternative payment models, such as episode-based payments or accountable care. Healthcare providers and hospitals would benefit from better understanding the impact and frequency of these infections in order to best target preventive strategies.