Document Detail


Costs of skin and skin structure infections due to Staphylococcus aureus: an analysis of managed-care claims.
MedLine Citation:
PMID:  18759996     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The incidence of skin and skin structure infections (SSSIs) due to Staphylococcus aureus (SA) is increasing. The objective of this study was to assess the costs of a treatment episode for SA-SSSIs. METHODS: This retrospective analysis used a managed-care claims database to assess the duration and costs of incident SA-SSSI episodes treated with selected antibiotics (i.v. vancomycin, oral linezolid, and daptomycin, termed 'study antibiotics'). Patients were included if they had an ICD-9-CM diagnosis of an SSSI and SA between January 1, 2002 and December 31, 2005. Treatment episodes began on the date of the first antibiotic and ended when the patient had fourteen consecutive days without a study antibiotic or SSSI hospitalization. Costs, represented by health plan payments for SSSIs and overall, were updated to 2005 US dollars. A generalized linear model (GLM) assessed predictors of costs. RESULTS: A total of 1997 patients met the selection criteria. Mean (+/- SD) age was 46.3 (+/- 12.6) years and 55.9% of patients were male. Average episode length was 24 days, and over 95% of patients received i.v. vancomycin or oral linezolid as their initial study antibiotic. Patients remained on study antibiotics for an average of 16.4 days, and only 5% of patients were switched to another study antibiotic. Mean (+/- SD) overall episode costs were $8865 (+/- $20,003), primarily composed of inpatient and outpatient medical services. Treatment failure (i.e., study antibiotic switching or hospitalization), younger age, a diagnosis of bacteremia, osteomyelitis, or multiple complications during the episode, treatment with daptomycin, and greater Charlson co-morbidity score were significant positive predictors of overall costs. Alternatively, treatment with oral linezolid and hospitalization before the start of the outpatient treatment episode were significant negative predictors of overall costs. Mean (+/- SD) SSSI-related costs were $4551 (+/- $11,058). LIMITATIONS: Medical charts and laboratory test results were not available to confirm SSSI and SA diagnoses, and no information was available regarding antibiotics received in the inpatient setting. CONCLUSIONS: The costs of treating SA-SSSIs are substantial and vary by failure rates, co-morbidities, and type of antibiotic therapy.
Authors:
Jeno P Marton; Juliana L Jackel; Robyn T Carson; Constance D Rothermel; Mark Friedman; Joseph Menzin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-08-28
Journal Detail:
Title:  Current medical research and opinion     Volume:  24     ISSN:  1473-4877     ISO Abbreviation:  Curr Med Res Opin     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-24     Completed Date:  2009-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  England    
Other Details:
Languages:  eng     Pagination:  2821-8     Citation Subset:  IM    
Affiliation:
Pfizer Inc., New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anti-Bacterial Agents / agonists*,  therapeutic use
Costs and Cost Analysis
Female
Hospitalization / economics*
Humans
Insurance Claim Review
Male
Middle Aged
Models, Theoretical*
Retrospective Studies
Staphylococcal Skin Infections / drug therapy,  economics*
Staphylococcus aureus*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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