Hospital costs for patients with lower extremity cellulitis: a retrospective population-based study

Published on Sep 27, 2017in Hospital Practice
· DOI :10.1080/21548331.2017.1384690
Douglas W. Challener9
Estimated H-index: 9
 (Mayo Clinic), Jasmine R Marcelin10
Estimated H-index: 10
 (UNMC: University of Nebraska Medical Center)+ 1 AuthorsLarry M. Baddour92
Estimated H-index: 92
 (Mayo Clinic)
Sources
Abstract
ABSTRACTObjectives: Hospital admissions for non-purulent lower extremity cellulitis (NLEC) are common and can be prolonged and costly. Newer treatment options and preventive strategies are expected to result in cost savings before implementation, but few studies have quantified the cost of conventional treatment.Methods: Using the Rochester Epidemiology Project, the incidence of NLEC in Olmsted County, MN in 2013 was 176.6 per 100,000 persons. The subset of patients who required hospitalization for NLEC in 2013 was determined. Hospital admissions were analyzed retrospectively using standardized cost analysis within several relevant categories.Results: Thirty-four patients had an average hospital length of stay of 4.7 days. The median total inpatient cost was 7,341. The median cost per day was ,087, with 49% due to room and board. Antibiotics administered for treatment of NLEC contributed a median cost of 75 per day of hospitalization, and laboratory and imaging test costs were 3 and $44, respectivel...
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References26
Newest
#1Jasmine R Marcelin (Mayo Clinic)H-Index: 10
#2Douglas W. Challener (Mayo Clinic)H-Index: 9
Last. Larry M. Baddour (Mayo Clinic)H-Index: 92
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Abstract Nonpurulent lower extremity cellulitis (NLEC) is a common clinical diagnosis, with β-hemolytic streptococci and Staphylococcus aureus considered to be the most frequent causes. In 1999, the US Public Health Service alerted clinicians to the presence of community-acquired methicillin-resistant S aureus (CA-MRSA) infections in 4 children in the upper Midwest. Since then, it has become a well-recognized cause of skin and soft-tissue infections, in particular, skin abscess. A previous popul...
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Jun 20, 2017·Cochrane Database of Systematic Reviews9.29
#1Adam Dalal (Rabin Medical Center)H-Index: 4
#2Marina Eskin-Schwartz (Rabin Medical Center)H-Index: 4
Last. Mical Paul (Rambam Health Care Campus)H-Index: 63
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Background Erysipelas and cellulitis (hereafter referred to as 'cellulitis') are common bacterial skin infections usually affecting the lower extremities. Despite their burden of morbidity, the evidence for different prevention strategies is unclear. Objectives To assess the beneficial and adverse effects of antibiotic prophylaxis or other prophylactic interventions for the prevention of recurrent episodes of cellulitis in adults aged over 16. Search methods We searched the following databases u...
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Jun 12, 2017·BMC Health Services Research2.65
#1Sue L. Visscher (Mayo Clinic)H-Index: 12
#2James M. Naessens (Mayo Clinic)H-Index: 56
Last. Bijan J. Borah (Mayo Clinic)H-Index: 26
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Research addressing value in healthcare requires a measure of cost. While there are many sources and types of cost data, each has strengths and weaknesses. Many researchers appear to create study-specific cost datasets, but the explanations of their costing methodologies are not always clear, causing their results to be difficult to interpret. Our solution, described in this paper, was to use widely accepted costing methodologies to create a service-level, standardized healthcare cost data wareh...
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Apr 1, 2017·Journal of The American Academy of Dermatology11.53
#1Amit Garg (Hofstra University)H-Index: 21
#2Jonathan Lavian (Hofstra University)H-Index: 5
Last. Bonnie Koo (Hofstra University)H-Index: 2
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Background Clinicians have limited ability to classify risk of prolonged hospitalization among patients with lower limb cellulitis. Objective We sought to identify characteristics associated with days to discharge and prolonged stay. Methods We conducted retrospective cohort analysis including patients admitted with a primary diagnosis of lower limb cellulitis at community and tertiary hospitals. Results There were 4224 admissions for lower limb cellulitis among 3692 patients. Mean age of the co...
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Apr 1, 2017·Diagnostic Microbiology and Infectious Disease2.80
#1Shilpa R. Jain (UWO: University of Western Ontario)H-Index: 1
#2Seyed M Hosseini-Moghaddam (UWO: University of Western Ontario)H-Index: 12
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Abstract Three hospital emergency rooms (ERs) routinely referred all cases of cellulitis requiring outpatient intravenous antibiotics, to a central ER-staffed cellulitis clinic. We performed a retrospective cohort study of all patients seen by the ER clinic in the last 4months preceding a policy change (ER management cohort [ERMC]) (n=149) and all those seen in the first 3months of a new policy of automatic referral to an infectious disease (ID) specialist–supervised cellulitis clinic (ID manage...
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Feb 1, 2017·JAMA Dermatology10.28
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Last. Arash Mostaghimi (Brigham and Women's Hospital)H-Index: 22
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Importance Inflammatory dermatoses of the lower extremity are often misdiagnosed as cellulitis (aka “pseudocellulitis”) and treated with antibiotics and/or hospitalization. There is limited data on the cost and complications from misdiagnosed cellulitis. Objective To characterize the national health care burden of misdiagnosed cellulitis in patients admitted for treatment of lower extremity cellulitis. Design, Setting, and Participants Cross-sectional study using patients admitted from the emerg...
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Jan 1, 2017·Open Forum Infectious Diseases3.83
#1Ryan A. PetersonH-Index: 7
#2Linnea A. PolgreenH-Index: 21
Last. Philip M. Polgreen (UI: University of Iowa)H-Index: 43
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: Using data from the National Inpatient Sample, 1998-2013, we show that hospitalizations for cellulitis have approximately doubled. Costs increased by 118% to $3.74 billion annually. In addition, hospitalizations for cellulitis are highly seasonal, peaking in summer months: incidence during the peak month of July is 35% higher than in February.
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Last. Michael Z. David (UIC: University of Illinois at Chicago)H-Index: 32
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: Background. The incidence of skin and soft tissue infections (SSTIs) in the United States increased sharply after 2000 with the emergence of USA300 methicillin-resistant Staphylococcus aureus. We examined trends in SSTI incidence in 2006-2014 at the University of Chicago Medicine (UCM). Methods. Data were obtained for patient encounters at UCM with an International Classification of Diseases, Ninth Revision-coded SSTI diagnosis between January 1, 2006 and March 31, 2014. Incidence density was ...
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Mar 1, 2016·Journal of Antimicrobial Chemotherapy5.79
#1Kamya KameshwarH-Index: 1
#2Amalia Karahalios (University of Melbourne)H-Index: 18
Last. Harin Karunajeewa (University of Melbourne)H-Index: 27
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The majority of healthcare costs accrued managing cellulitis can be attributed to the small proportion of patients treated with parenteral antibiotics. Hospital in the home (HITH) instead of or following initial inpatient treatment is a safe and effective alternative, but there are few data evaluating its cost-effectiveness for cellulitis.Our retrospective cohort study included all treatment episodes (by either HITH or an inpatient service for >24 h) with an ICD-10 primary diagnosis code of lowe...
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Apr 1, 2015·Journal of Emergency Medicine1.48
#1Charles V. Pollack (UPenn: University of Pennsylvania)H-Index: 86
#2Alpesh Amin (UCI: University of California, Irvine)H-Index: 38
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Abstract Background Acute bacterial skin and skin structure infections (ABSSSI), formally referred to as complicated skin and soft tissue infections, include infections with resistance to previously effective antimicrobials. Increasing dramatically in incidence, they have become a challenging medical problem associated with high direct and indirect costs to both the medical system and society. Objectives To describe the burden of ABSSSI and to explore multidisciplinary approaches to its manageme...
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Early diagnosis of wound-related cellulitis is challenging as many classical signs and symptoms of infection (erythema, pain, tenderness, or fever) may be absent. In addition, other conditions (ie, chronic stasis dermatitis) may present with similar clinical findings. Point-of-care fluorescence imaging detects elevated bacterial burden in and around wounds with high sensitivity. This prospective observational study examined the impact of incorporating fluorescence imaging into standard care for ...
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OBJECTIVES To determine the impact of infection (INF) on medical resource utilization (MRU) and cost of care in venous leg ulcer (VLU) patients. METHODS We performed a retrospective case-controlled study of 78 patients followed for a minimum of 12 months with C6 VLUs treated by vascular surgeons, at our wound center. To eliminate either minor episodes of INF or incorrectly diagnosed episodes, only patients who had an inpatient admission specifically for INF comprised the INF GROUP, while all oth...
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Abstract null null Erysipelas is a skin and soft tissue infection, often confused with cellulitis, that is not well researched or understood in the medical literature. The incidence of erysipelas has been estimated to be from 10 to 100 cases per 100,000 individuals per year. However, these estimates may be inaccurate due to erysipelas cases being classified under the broader diagnosis of cellulitis. The aim of this article is to increase nurse practitioner awareness of erysipelas, how it manifes...
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Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other ...
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INTRODUCTION: Novel long-acting lipoglycopeptide antibiotics allow for the treatment and discharge of selected emergency department (ED) patients with cellulitis who require intravenous antibiotics. Telehealth systems have shown success in remote management of dermatologic conditions; we implemented a telehealth follow-up program for patients diagnosed with cellulitis in the ED, treated with single-dose dalbavancin, and discharged. METHODS: This was a prospective, multi-center observational stud...
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