The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in Italy
Introduction: The infections of multidrug-resistant organisms (MDROs) associated with duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedure have become a significant cause for concern, especially in fragile patients. While the clinical impacts of these infections are w...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
AboutScience Srl
2024-12-01
|
| Series: | Global & Regional Health Technology Assessment |
| Subjects: | |
| Online Access: | https://journals.aboutscience.eu/index.php/grhta/article/view/3186 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841527535574188032 |
|---|---|
| author | Paolo Sciattella Annarosa Fornero Susanna Giordano Claudio De Angelis Francesco Cattel |
| author_facet | Paolo Sciattella Annarosa Fornero Susanna Giordano Claudio De Angelis Francesco Cattel |
| author_sort | Paolo Sciattella |
| collection | DOAJ |
| description | Introduction: The infections of multidrug-resistant organisms (MDROs) associated with duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedure have become a significant cause for concern, especially in fragile patients. While the clinical impacts of these infections are well-documented, their economic implications remain underexplored. This study assesses the incidence and economic burden of post-ERCP infections in Italy using an administrative database.
Methods: We conducted a retrospective observational study using administrative databases from A.O.U. Città della Salute e della Scienza di Torino. The study included all patients who underwent their first inpatient ERCP between 2018 and 2021. Infections were identified using ICD-9-CM codes for Pseudomonas aeruginosa, Clostridium difficile, Escherichia coli, Klebsiella spp., and Staphylococcus aureus. A 1-year follow-up was defined in order to estimate healthcare resource utilization and related costs, including readmissions, drug prescriptions, and outpatient specialist and laboratory services.
Results: The study included 686 inpatient ERCP cases, an overall infection rate of 4.2% was observed. Higher infection rates were observed in women (4.6%), patients over 70 years old (4.6%), emergency admissions (5.1%), and transplant patients (19.1%). The average hospital stay doubled for infected patients (24.3 vs. 11.3 days; p=0.001). Post-ERCP infections led to a 28% increase in average costs (€12,256 vs. €9,561; p=0.048). With an annual volume of 25,000 ERCP procedures, post-ERCP infections in Italy contribute approximately €2.9 million in additional direct costs per year.
Conclusion: Post-ERCP infections impose substantial financial burdens on the healthcare system, underscoring the critical importance of implementing cost-effective prevention strategies to mitigate this public health threat in Italy.
|
| format | Article |
| id | doaj-art-b6e8bcce227743e6a3bb31d7235e6cdf |
| institution | Kabale University |
| issn | 2284-2403 2283-5733 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | AboutScience Srl |
| record_format | Article |
| series | Global & Regional Health Technology Assessment |
| spelling | doaj-art-b6e8bcce227743e6a3bb31d7235e6cdf2025-01-15T14:02:59ZengAboutScience SrlGlobal & Regional Health Technology Assessment2284-24032283-57332024-12-0111110.33393/grhta.2024.3186The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in ItalyPaolo Sciattella0Annarosa Fornero1Susanna Giordano2Claudio De Angelis3Francesco Cattel4Centre for Economics and International Studies – Economic Evaluation and Health Technology Assessment (EEHTA-CEIS), University of Rome “Tor Vergata”, Rome - ItalyDepartment of Hospital Pharmacy, Città della Salute e della Scienza di Torino, Turin - ItalyDepartment of Hospital Pharmacy, Città della Salute e della Scienza di Torino, Turin - ItalyDepartment of General and Specialist Medicine, Gastroenterologia-U, Città della Salute e della Scienza di Torino, Turin - ItalyDepartment of Hospital Pharmacy, Città della Salute e della Scienza di Torino, Turin - ItalyIntroduction: The infections of multidrug-resistant organisms (MDROs) associated with duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedure have become a significant cause for concern, especially in fragile patients. While the clinical impacts of these infections are well-documented, their economic implications remain underexplored. This study assesses the incidence and economic burden of post-ERCP infections in Italy using an administrative database. Methods: We conducted a retrospective observational study using administrative databases from A.O.U. Città della Salute e della Scienza di Torino. The study included all patients who underwent their first inpatient ERCP between 2018 and 2021. Infections were identified using ICD-9-CM codes for Pseudomonas aeruginosa, Clostridium difficile, Escherichia coli, Klebsiella spp., and Staphylococcus aureus. A 1-year follow-up was defined in order to estimate healthcare resource utilization and related costs, including readmissions, drug prescriptions, and outpatient specialist and laboratory services. Results: The study included 686 inpatient ERCP cases, an overall infection rate of 4.2% was observed. Higher infection rates were observed in women (4.6%), patients over 70 years old (4.6%), emergency admissions (5.1%), and transplant patients (19.1%). The average hospital stay doubled for infected patients (24.3 vs. 11.3 days; p=0.001). Post-ERCP infections led to a 28% increase in average costs (€12,256 vs. €9,561; p=0.048). With an annual volume of 25,000 ERCP procedures, post-ERCP infections in Italy contribute approximately €2.9 million in additional direct costs per year. Conclusion: Post-ERCP infections impose substantial financial burdens on the healthcare system, underscoring the critical importance of implementing cost-effective prevention strategies to mitigate this public health threat in Italy. https://journals.aboutscience.eu/index.php/grhta/article/view/3186Economic burdenEndoscopic retrograde cholangiopancreatographyHealthcare resource utilizationMultidrug resistantPost-ERCP infectionsReal-world data |
| spellingShingle | Paolo Sciattella Annarosa Fornero Susanna Giordano Claudio De Angelis Francesco Cattel The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in Italy Global & Regional Health Technology Assessment Economic burden Endoscopic retrograde cholangiopancreatography Healthcare resource utilization Multidrug resistant Post-ERCP infections Real-world data |
| title | The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in Italy |
| title_full | The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in Italy |
| title_fullStr | The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in Italy |
| title_full_unstemmed | The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in Italy |
| title_short | The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in Italy |
| title_sort | economic burden of post endoscopic retrograde cholangiopancreatography ercp procedure infections in italy |
| topic | Economic burden Endoscopic retrograde cholangiopancreatography Healthcare resource utilization Multidrug resistant Post-ERCP infections Real-world data |
| url | https://journals.aboutscience.eu/index.php/grhta/article/view/3186 |
| work_keys_str_mv | AT paolosciattella theeconomicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT annarosafornero theeconomicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT susannagiordano theeconomicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT claudiodeangelis theeconomicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT francescocattel theeconomicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT paolosciattella economicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT annarosafornero economicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT susannagiordano economicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT claudiodeangelis economicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly AT francescocattel economicburdenofpostendoscopicretrogradecholangiopancreatographyercpprocedureinfectionsinitaly |