Hospital admission costs of acute injection-related infections among people who inject drugs

Introduction

There are limited existing data regarding the financial costs associated with hospitalisation for injection-related infection (IRI) in Australia. We aimed to estimate the cost, from the healthcare funder perspective, of admissions to treat IRI.

Methods

We performed a retrospective audit of 226 admissions with an IRI at the Alfred Hospital (Melbourne, Australia), from January 2017 to April 2019. Eligibility criteria included admission for management of an IRI and current injecting drug use, defined as self-reported injecting drug use within the preceding 6 months, documented in the medical record. We estimated the cost of each hospital admission, using national hospital price weights that accounted for the Australian Refined Diagnosis Related Groups and length of stay.

Results

Among admissions with IRI, the median (interquartile range; IQR) cost of admissions with uncomplicated skin and soft tissue infection and complicated infection were AU$8416 (IQR $4132–$8611) and AU$31,938 (IQR $14,301–$54,397), respectively. Admissions requiring intensive care or surgery were associated with higher costs. The most expensive infection based on hospital cost was spinal infections (median AU$58,366 [IQR 31,938–$69,001]), despite endocarditis having higher median length of stay (38 days [IQR 18–46] vs. 24 [15–32]).

Discussion and Conclusions

We demonstrate the costs associated with hospital admissions for IRI, including the substantial increased costs associated with complicated IRI. This highlights the opportunity for cost savings associated with harm minimisation interventions to avoid infections and their sequelae.