Healthcare costs of methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa infections in veterans: role of vitamin D deficiency.
Eur J Clin Microbiol Infect Dis. 2011 Jun 22.
Youssef D, Bailey B, El-Abbassi A, Vannoy M, Manning T, Moorman JP, Peiris AN.
Department of Internal Medicine, Division of Infectious Diseases, East Tennessee State University, Johnson City, TN, USA, estecina at hotmail.com.
Methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (P. aeruginosa) infections are frequently associated with hospitalization and increased healthcare costs.
Vitamin D deficiency may contribute to increased costs for patients with these infections and there is evidence that vitamin D may have an antimicrobial role.
To evaluate the role of vitamin D deficiency in the costs incurred with these infections, we studied the relationship of serum 25(OH)D levels to healthcare costs in veterans in the southeastern United States.
Patients with both infections were vitamin D deficient to a similar extent and so were combined for further analysis. Vitamin D deficient patients had higher costs and service utilization than those who were not vitamin D deficient.
Those with vitamin D deficiency had higher inpatient costs compared to the non-deficient group, and this difference was across most categories except for the number of inpatient hospitalizations or total number of days as an inpatient.
Vitamin D deficiency was not significantly related to outpatient cost or service utilization parameters.
We conclude that vitamin D deficiency is intimately linked to adverse healthcare costs in veterans with MRSA and P. aeruginosa infections. Vitamin D status should be assayed in patients with these infections.
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Table 2 Associations between vitamin D status and cost/ service parameters in veterans (N = 58) with MRSA or Pseudomonas infections
Vitamin D level p <20 ng/ml >20 ng/ml
|Primary care costs||$296||$321||0.41|
|Emergency room costs||$87||$172||0.25|
|Total outpatient costs||$12,665||$15,869||0.23|
|Total number of clinic visits||29.6||37.5||0.18|
|Total inpatient costs||$39,640||$15,205||0.04|
|Total number of stays||1.3||1.3||0.95|
|Total number of inpatient days||18.5||10.2||0.14|
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