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Infection  /  Cost of Disease

Every year, between 50,000 and 90,000 adults in the U.S. die from vaccine-preventable infectious diseases or their complications. Many serious infectious diseases are acquired in the healthcare setting and those healthcare-associated infections cost U.S. hospitals between $28.4 and $45 billion each year.

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    • Unplanned Hospital Readmissions & Costs Following Sepsis Hospitalizations
      Among 187,697 hospital admissions for medical reasons that were associated with an unplanned 30-day readmission,  147,084 had a diagnosis of sepsis, 15,001 had a diagnosis of AMI, 79,480 were diagnosed with heart failure, 54,396…  
    • Cost of infectious disease in unvaccinated individuals
      Unvaccinated individuals are responsible fror almost 80% ($7.1 billion) of the $9 billion economic burden of vaccine-preventable diseases in 2015.  Note that the cost is based on the vaccine-preventable illnesses…  
    • Cost of vaccine-preventable diseases
      Vaccine-preventable diseases relevant to the ten vaccines recommended for US adults, cost an estimated $9 billion in 2015.  
    • Sepsis in hospitalized patients
      Hospitalized patients with sepsis who survived to 31 days experienced a 16.2% absolute increase in late mortality.  
    • Late Mortality and Sepsis
      Compared with patients not in the hospital, sepsis in hospitalized patients was associated with a 22.1%  increase in late mortality during a 2 year follow-up period.  
    • HAI Annual Cost
      Healthcare-associated infections in US hospitals cost $96–$147 billion annually.  
    • Comorbidities and hospitalization higher with HAIs
      Patients with HAIs have more comorbidities (2.8 vs. 1.9) and in-hospital mortality (9% vs. 1.5%), compared to all other hospitalized patients.  
    • Sepsis accounts for nearly 1/2 of ICU expenditures
      Infection and related sepsis/septicemia account for 40% of all ICU expenditures.  
    • ~70% of hospital HAIs resistant to ≥ antimicrobial
      Approximately 70% of hospital-acquired HAIs are resistant to at least one antimicrobial drug.  
    • Dramatic increase of antibiotic resistance between 1981 and 2001
      Increase in antibiotic resistance over 20 year period  
    • Source of 99,000 annual deaths from HAIs
      Of the 99,000 annual deaths from HAIs: 35,967 are from pneumonia 30,665 are from bloodstream infections 13,088 are from urinary tract infections 8,205 are from surgical site infections; and 11,062 are from infections at other…  
    • Antibacterial resistant pathogens responsible for most of 99,000 HAI related deaths
      The majority of the 99,000 patients who die from healthcare-associated infections each year, are due to antibacterial-resistant pathogens.  
    • Hospital stays longer when HAIs involved
      The average length of hospital stays are 19 days longer with healthcare-associated infections than without (24.4 days versus 5.2 days).  
    • Most common principal diagnoses for hospitalized patients with HAIs
      The most common principal diagnoses for hospitalized patients with HAIs are: Septicemia 11.8% Adult respiratory failure 5.9% Complications from surgical or medical care 4.1%  
    • >20% of drug-resistant pneumonia in nursing homes
      More than 20% of drug-resistant cases of pneumonia in 2010 occurred in nursing home residents.  
    • Majority of C. diff deaths in ages 65+
      More than 90% of deaths from C. difficile infectious occur in people ages 65 and older.  
    • Sepsis hospitalization rate increases with age
      The rate of hospitalization for sepsis/septicemia in 2008 was around 30 times higher for patients ages 85 and older, than for those under the age of 65.  
    • Risk of HAIs from hospitalization increases with age
      Hospitalized elderly patients are 2 – 5 times more likely to develop a healthcare-associated infection than younger patients.  
    • Enormous annual direct cost of HAIs to hospitals
      The annual direct cost of healthcare-associated infections to U.S. hospitals ranges from $28.4 billion to $45 billion.  
    • 10 most common pathogens leading to HAIs
      The 10 most common pathogens leading to HAIs: Coagulase-negative staphylococci 15% Staphylococcus aureus 15% Enterococcus species 12% Candida species 11% Escherichia coli 10% Pseudomonas aeruginosa 8% Klebsiella pneumoniae 6% Enterobacter species 5% Acinetobacter baumannii 3% Klebsiella oxytoca 2%  
    • 75% of c. diff infections start in places like nursing homes and physician offices
      75% of clostridium difficile (C. difficile) infections, a common HAI, start in places like nursing homes and physician offices.  
    • ~1 in 20 hospitalized patients will get an HAI
      Around 1 in 20 hospitalized patients will contract a healthcare-associated infection, the most common complication of hospital care.  
    • ~1.7 million Americans develop hospital-acquired HAIs annually
      Approximately 1.7 million Americans develop hospital-acquired HAIs each year.  
    • MRSA kills more than emphysema, HIV/AIDS, Parkinson’s, and homicide combined
      In one year, MRSA killed more Americans (~19,000) than emphysema, HIV/AIDS, Parkinson’s disease, and homicide combined.  
    • MRSA infections increase in older patients
      In 2008, 75% of healthcare-associated invasive MRSA infections occurred in patients older than 50, with 46% in patients older than 65%.  
    • Close to 1/2 of HAIs in patients 65+
      Around 45% of all hospital-acquired HAIs in 2007 were in patients age 65 and older.  
    • ~3/4 of all HAIs occur outside of ICU
      Nearly 3/4 of all hospital-acquired HAIs occur outside of the intensive care unit (ICU).  
    • Primary sources of HAIs
      Around 2/3 of all HAIs are central-line associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonia. Surgical site infections and Clostridium difficile (C. difficile) are also common HAIs.  
    • HAIs cost patients additional $43,000 per hospital stay
      Patients with HAIs cost, on average, $43,000 more per hospital stay than those without an infection ($52,096 vs. $9,377).  
    • Drug-resistant MRSA expensive to treat
      As an example, the median treatment cost for drug-resistant MRSA patients over a 6-month period was 118% higher than the cost of treating drug-susceptible MRSA strains.  
    • Around $35 billion cost to society from antibiotic resistant infections
      The societal costs of antibiotic resistant infections are around $35 billion each year- this includes the cost of lost wages and premature deaths.  
    • Drug resistant infections cost $16.6 – $26 billion to US healthcare system annually
      Drug-resistant infections cost the U.S. healthcare system between $16.6 and $26 billion in extra costs each year.  
    • Drug-resistant infections increase length & cost of hospital stays
      Drug-resistant infections increase the length of hospital stays by more than 23% and the cost by close to 30%.  
    • Infection and related sepsis leading cause of death in noncardiac-ICUs
      Infection and related sepsis/septicemia are the leading cause of death in noncardiac-ICUs, accounting for as many as 60% of deaths.  
    • Sepsis accounts for 17% of in-hospital deaths
      In 2008, only 2% of hospitalization were for sepsis/septicemia, yet they made up 17% of in-hospital deaths.  
    • Patients hospitalized for sepsis experience poor outcomes
      Compared with patients hospitalized with other diagnoses, patients hospitalized for sepsis/septicemia are: 1/2 as likely to be discharged home 2 times more likely to be discharged to other short-term care 3 times more…  
    • 1 in 10 HAI hospital stays from sepsis
      1 in 10 hospital stays with HAIs have a principal diagnosis of septicemia.  
    • C. difficile-related deaths on the rise
      Between 1999 and 2004, C. difficile-related deaths in the U.S. increased 35% each year.  
    • Significant increase of penicillin-resistant Streptococcus penumoniae
      High-level penicillin-resistant Steptococcus pneumoniae increased 1,000-fold over 17 years.  
    • Antibiotic resistance of Klebsiella pneumoniae on the rise
      Resistance of Klebsiella pneumoniae to antibiotics has dramatically increased- from 5.3% to 11.6% for third generation cephalosporins (between 1999 and 2010), and from <0.1% to 4.5% for carbapenams (between 2002…  
    • Majority of physicians treated patient with at least 1 drug-resistant infection
      63% of surveyed infectious disease physicians treated a patient with at least one drug-resistant infection in 2011. 56% believed those infections to be on the rise.  
    • Pneumonia Death Rate by Age in 2004
      Pneumonia Death Rate Per 100,000 By Age: United States, 2004  
    • Flu causes close to 1/2 of lost workdays and low productivity in adults 50-64 during flu season
      During influenza season, influenza-like-illness is responsible for 45% of workdays lost and for 49% of low productivity days among working adults aged 50–64 years.  
    • Shingles causes an average of 129 hours lost work per episode
      Patients with shingles (including those progressing to postherpetic neuralgia) lose an average of over 129 hours of work per episode, including losses of 12 or more hours of work time  
    • Vaccine-eligible account for majority of shingles-related hospitalizations
      The shingles vaccine-eligible population (i.e., persons aged 60 years or older) accounted for 74% of the total annual shingles-related hospital charges in 2004.  
    • Costs of shingles
      Among patients with acute episodes of shingles, average expenditures ranged from $112 to $287 per episode of outpatient care, $73 to $180 per antiviral treatment, and $3,221 to $7,206 per…  
    • Flu costs US $16.3 billion in lost earnings each year
      Lost productivity and loss of life due to influenza amounts to $16.3 billion of lost earnings annually.  
    • >1/2 of flu’s economic burden from people 65+
      An estimated 64% of the total economic burden of influenza comes from those over 65 years old.  
    • Medical expenses for Medicare patients with pneumonia higher
      Medicare patients hospitalized for pneumonia have medical expenses—during the hospitalization and for a year afterwards—that are $15,682 higher than in Medicare patients without pneumonia.  
    • Cost of hospital-treated pneumonia in Medicare patients
      Hospital-treated pneumonia in Medicare patients cost at least $7 billion in 2010.  
    • Cost of pneumonia and flu more than $40 billion in 2005
      In 2005, pneumonia and influenza combined cost the U.S. $40.2 billion—$34.2 in direct costs and $6 billion in indirect mortality costs.  
    • Shingles pain occurs in ~50% of cases in older adults
      Complications of shingles—including postherpetic neuralgia (PHN)—occur in almost 50 percent of older persons with the disease.  
    • Shingles causes >50,000 hospitalizations each year
      Shingles causes around 50,000 to 60,000 hospitalizations each year in the United States.  
    • Increase in flu mortality between 1970 and 1990
      Mortality from influenza increased from between 7,000 and 32,000 annual deaths in the 1970s, to between 36,000 and 72,000 annual deaths in the 1990s.  
    • Flu fatality rates in long-term care facilities
      Case-fatality rates from influenza in residents of long-term care facilities range from 10% to 20%.  
    • Influenza-associated deaths
      The annual number of influenza-associated deaths from respiratory and circulatory cases varies widely from year-to-year, ranging from an estimated 3,349 to 48,614.  
    • Lost productivity and healthcare visits due to flu
      In one year (1995), influenza was responsible for more than: 200 million days of restricted activity 100 million days of bed disability 75 million work absenteeisms 22 million health care provider visits  
    • Healthcare use due to flu
      In the U.S. influenza epidemics lead to around: • 600,000 life years lost • 3 million hospitalized days • 30 million outpatient visits  
    • Hospitalization rate from flu epidemics
      Every influenza epidemic, between 55,000 and 431,000 Americans are hospitalized, with a mean annual hospitalization rate of 226,000.  
    • Mortality rate from hospital-acquired pneumonia
      The mortality rate for hospital-acquired pneumonia ranges from 38% to more than 70%.  
    • In 1998, community-acquired pneumonia was 6th leading cause of death
      Community-acquired pneumonia is the sixth leading cause of death in the U.S. and the number-one cause of death from infection.  
    • Pneumonia killed ~50,000 people in 2010
      In 2010, pneumonia killed around 50,000 Americans.  
    • 1 in 4 inpatient pneumonia hospitalizations due to HAIs
      In one study, one in four inpatient pneumonia hospitalizations were from health-care-associated pneumonia.  
    • Hospitalizations due to pneumonia
      Community-acquired pneumonia is responsible for 350,000 – 620,000 hospitalizations each year in Americans age 65 and older.  
    • Increased rate of hospitalization from shingles
      Hospitalization rates for shingles are 75 times higher in people over 85 than those younger than 30.  
    • 1 in 2 people who live to 85 will get shingles
      Around 1 in 2 people who live to be 85 will get shingles.  
    • Death rate from pneumonia and flu rises significantly with age
      The death rate from pneumonia and influenza is close to 130 times higher in people age 85 and older, compared to people ages 45 to 54. This increased risk due…  
    • Medicare hospitalization rates from pneumonia
      Elderly Medicare patients are hospitalized with community-acquired pneumonia at a rate of 18.3 per 1000, compared to 4 per 1000 in younger populations.  
    • Pneumonia in people age 85+
      In the U.S., 1 in every 20 individuals age 85 and older will have a new episode of community-acquired pneumonia each year.  
    • >900,000 cases of pneumonia each year
      Each year, more than 900,000 cases of community-acquired pneumonia are estimated to occur in seniors in the U.S.  
    • 1 in 3 people will develop shingles
      An estimated 1 in 3 people will develop shingles in their lifetime.  
    • ~1 million Americans get shingles each year
      Around 1 million Americans get herpes zoster (shingles) each year.  
    • Flu rates in long-term care facilities
      Residents of long-term care facilities are particularly vulnerable to influenza, with rates of illness that range as high as 25% to 60%.  
    • Every year 5 to 20% of US population gets the flu
      Every year around 5% to 20% of the U.S. population gets influenza.  
    • Annual incidence of pneumonia in Medicare population
      In Medicare beneficiaries, the average cumulative annual incidence of any type of pneumonia was 47.4 per 1,000 from 2005 to 2007.  
    • Pneumonia in nursing home residents
      Every year an estimated 2.3% of nursing home residents acquire pneumonia—more than 33,000 residents.  
    • 5 to 10 million Americans get pneumonia each year
      Between 5 and 10 million Americans get pneumonia each year.  
    • Lost work due to shingles
      Shingles patients lose an average 129 hours of work per episode.  
    • Annual cost of shingles
      Shingles cost ~$1 billion in indirect and direct medical expenses each year.  
    • Lost productivity due to flu
      During flu season, in working adults ages 50 to 64 years old, flu-like illness is responsible for 45% of workdays lost and 49% of low-productivity days.  
    • Annual cost of flu
      The annual direct and indirect cost of flu in the U.S. is more than $87 billion.  
    • Higher hospitalization costs due to pneumonia
      Medicare beneficiaries hospitalized for pneumonia have $15,682 higher expenses than those without the infection.  
    • Physician visits due to infectious diseases
      1 in 4 physician visits are due to infectious diseases.  
    • Infectious diseases 15% of all healthcare expenditures
      The annual direct & indirect medical cost of infectious diseases is $120 million, 15% of all U.S. healthcare expenditures.  
    • Tremendous impact of flu epidemics
      Flu epidemics in the U.S. lead to approximately: 600,000 life years lost 3,000,000 days of hospitalization 30,000,000 outpatient visits 48,000 deaths  
    • Pneumonia leading cause of death and infection
      Community-acquired pneumonia was the #6 cause of death and the #1 cause of death from infection in the U.S. in 2003.  
    • Pneumonia is the 5th most frequent cause of hospitalization in the US
      Pneumonia is the 5th most frequent cause of hospitalization in the U.S.  
    • Postherpetic neuralgia in shingles
      Complications, including postherpetic neuralgia (PHN) occur in ~50% of older persons with shingles.  
    • Mortality from vaccine-preventable diseases
      Vaccine-preventable diseases or their complications account for 50,000 to 90,000 adult deaths in the U.S. each year.  
    • Infectious diseases lead to hospitalization
      Number of infectious disease cases that lead to hospitalization every year: Pneumonia >1.1 million Shingles 50,000 to 60,000 Influenza 55,000 to 431,000  
    • Hospitalization rates in shingles patients rises with age
      Hospitalization rates for people with shingles are 75 times higher for people age 85+ than for those under the age of 30.  
    • Hospitalizations from flu increase with age
      People age 65+ account for 50% of flu hospitalizations.  
    • Mortality rates from flu and pneumonia rise significantly with age
      Death rate from pneumonia and flu is 130x higher for ages 85+ compared with people ages 45 to 54. This increased risk due to age is higher than that seen…  
    • 1 in 20 age 85+ will have pneumonia
      Every year 1 in 20 Americans age 85+ will have an episode of community-acquired pneumonia.  
    • Hospital-acquired pneumonia leading cause of HAI
      Hospital-acquired pneumonia (HAP) is the 2nd most frequent cause of hospital-acquired infection, numbering around 300,000 cases each year.  
    • High odds of shingles after age 85
      Around 1 in 2 who live to be 85 will get shingles.  
    • 5 – 20% of the U.S. population gets the flu each year
      Between 5% and 20% of the U.S. population gets the flu each year.  
    • Annual pneumonia, flu, and shingles cases
      Approximate annual number of new cases of leading infectious diseases in US: Pneumonia – 5 to 10 million Influenza – 35 to 50 million Herpes zoster (shingles) – 1 million