Purpose: Our study determines changes in incidence and first year 1998 costs of serious fungal infections by type and diagnosis. Methods: We use multiple years of national and state data to determine incidence and incremental costs for candidiasis, aspergillosis, cryptococcosis, and histoplasmosis. A case-control method matching on diagnosis and student's t test to determine significance of hospital costs between cases and controls was used. We model outpatient care based on discharge status. Sensitivity analysis is calculated. Results: Incidence is 306/million population. Candidiasis accounts for 75% of cases. Rates of infection decreased slightly for HIV/AIDs cases. Total direct cost is $2.6 billion, with candidiasis 66% of costs. The largest per person cost is for aspergillosis ($72,800). The most commonly reported diagnoses associated with fungal infections (HIV/AIDS, neoplasms, transplants) accounted for only 45% of all infections. Of these diagnoses, transplants incurred the greatest per person hospital costs ($53,470) but only 1 % of cases, with HIV/AIDS fungal cases costing the lowest ($4,128) for 22% of cases. Of this 'other' group, patients with respiratory infections accounted for the majority (28%). Outpatient costs were greatest for those discharged home (75%). 7% died in hospital. Conclusion: We demonstrate for the first time, a stabalization in incidence across recent years, and slight decrease for HIV/AIDS, after the large increases reported earlier. The burden of fungal infections is high considering U.S. health expenditures per person are $4,094, and $31,200 for fungal infections. More attention should be given to the 55% with fungal disease and 'other 'diagnoses.
Learning Objectives: At the conclusion of the session, the participant will be able to: 1. Identify changes in rates of serious fungal infections in the U.S. 2. Articulate a model for assessment of the cost burden of serious fungal infections 3. Identify the distribution of of fungal infections among hospitalized medical diagnoses 4. Identify the cost burden of fungal disease in the U.S. and the predominant payor
Keywords: Epidemiology, Healthcare Costs
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.