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Costs and Outcomes of 1-year post-discharge care trajectories of patients admitted with infection due to antibiotic-resistant bacteria

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  • Mehdi Touat

    (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, EMAE - Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials - IP - Institut Pasteur [Paris] - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Christian Brun-Buisson

    (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, EMAE - Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials - IP - Institut Pasteur [Paris] - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Marion Opatowski

    (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, EMAE - Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials - IP - Institut Pasteur [Paris] - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Jérôme Salomon

    (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, Hôpital Raymond Poincaré [AP-HP], EMAE - Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials - IP - Institut Pasteur [Paris] - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Didier Guillemot

    (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, Hôpital Raymond Poincaré [AP-HP], EMAE - Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials - IP - Institut Pasteur [Paris] - INSERM - Institut National de la Santé et de la Recherche Médicale)

  • Philippe Tuppin

    (CNAMTS - Caisse Nationale d'Assurance Maladie des Travailleurs salariés - Ministère de l'économie et des finances)

  • Grégoire de Lagasnerie

    (CNAMTS - Caisse Nationale d'Assurance Maladie des Travailleurs salariés - Ministère de l'économie et des finances)

  • Laurence Watier

    (CESP - Centre de recherche en épidémiologie et santé des populations - UVSQ - Université de Versailles Saint-Quentin-en-Yvelines - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay, Hôpital Raymond Poincaré [AP-HP], EMAE - Epidémiologie et modélisation de la résistance aux antimicrobiens - Epidemiology and modelling of bacterial escape to antimicrobials - IP - Institut Pasteur [Paris] - INSERM - Institut National de la Santé et de la Recherche Médicale)

Abstract

Background: The impact of antibiotic resistance (AMR) on initial hospital management has been extensively studied but its consequences after hospital discharge remain largely unknown. We aimed to analyze hospital care trajectories, cumulative length of hospital stays (c-LOS) and associated costs of care over a 1-year period after hospitalization with incident AMR infection. Method: All incident bacterial infection-related hospitalizations occurring from January 1, 2015, to December 31, 2015 and recorded in the French national health data information system were extracted. Bacterial resistance ICD-10 codes determined six infection status. Inpatient and outpatient care consumption and associated costs were studied. The impact of resistance on c-LOS was estimated using a Poisson regression. A sequence analysis through optimal matching method was conducted to identify hospital trajectories along with an extrapolation. Finding: Of the 73,244 patients selected, 15.9% had AMR infection, thus providing 58,286 incident AMR infections after extrapolation. c-LOS was significantly longer for infections with resistant bacteria, reaching 20.4 days and 2.9 additional days IC95%[2.6; 3.2] for skin and soft tissue infections. An estimated 29,793 (51.1%) patients had hospital readmission within the following year, for a total cost of €675 million. Five post-discharge trajectories were identified: Post-hospitalization mainly at home (68.4% of patients); Transition to home from rehabilitation care (12.3%); Early death (

Suggested Citation

  • Mehdi Touat & Christian Brun-Buisson & Marion Opatowski & Jérôme Salomon & Didier Guillemot & Philippe Tuppin & Grégoire de Lagasnerie & Laurence Watier, 2021. "Costs and Outcomes of 1-year post-discharge care trajectories of patients admitted with infection due to antibiotic-resistant bacteria," Post-Print hal-03188146, HAL.
    • Handle: RePEc:hal:journl:hal-03188146
    DOI: 10.1016/j.jinf.2021.02.001
    Note: View the original document on HAL open archive server: https://hal.science/hal-03188146
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    References listed on IDEAS

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    1. Gabadinho, Alexis & Ritschard, Gilbert & Müller, Nicolas S & Studer, Matthias, 2011. "Analyzing and Visualizing State Sequences in R with TraMineR," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 40(i04).
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    1. Torrini, Irene & Lucifora, Claudio & Russo, Antonio Giampiero, 2023. "The long-term effects of hospitalization on health care expenditures: An empirical analysis for the young-old population in Lombardy," Health Policy, Elsevier, vol. 132(C).

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