TY - JOUR
T1 - A cost analysis of hospitalizations for infections related to injection drug use at a county safety-net hospital in Miami, Florida
AU - Tookes, Hansel
AU - Diaz, Chanelle
AU - Li, Hua
AU - Khalid, Rafi
AU - Doblecki-Lewis, Susanne
N1 - Funding Information:
We would like to thank the Infectious Diseases Society of America Medical Scholars Program and the Jackson Memorial Hospital Department of Internal Medicine Resident Scholarly Activity Program for funding this study. We would also like to thank Jonathan Robinson for data collection. Finally we would like to thank Jose Szapocznik, Stephen Symes, Leonardo Tamariz and Tanya Zakrison for their individual contributions to the study.
Funding Information:
Only 8% (n = 27) of IDUs had private insurance. State-funded Medicaid programs were billed for 41% (n = 142) of patients. Federally-funded Medicare was billed for 15% (n = 54) of patients. Of the IDUs in the cohort, 36% (n = 126) were uninsured. Care for indigent patients at Jackson Memorial Hospital is supported by the taxpayers of Miami-Dade County via a 0.5% sales tax levied since 1991 for the Public Health Trust. Seventeen patients (5%) died during the hospital stay as determined by a discharge status of “expired.”
Publisher Copyright:
© 2015 Tookes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2015/6/15
Y1 - 2015/6/15
N2 - Background: Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated. Methods and Findings: IDUs discharged from Jackson Memorial Hospital were identified using the International Classification of Diseases, Ninth Revision, codes for illicit drug abuse and endocarditis, bacteremia or sepsis, osteomyelitis and skin and soft tissue infections (SSTIs). 349 IDUs were identified for chart abstraction and 92% were either uninsured or had publicly funded insurance. SSTIs, the most common infection, were reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients (4.9%) died during their hospitalization. The total cost for treatment for injection drug use-related infections to Jackson Memorial Hospital over the 12-month period was $11.4 million. Conclusions: Injection drug use-related bacterial infections represent a significant morbidity for IDUs in Miami-Dade County and a substantial financial cost to the county hospital. Strategies aimed at reducing risk of infections associated with injection drug use could decrease morbidity and the cost associated with these common, yet preventable infections.
AB - Background: Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated. Methods and Findings: IDUs discharged from Jackson Memorial Hospital were identified using the International Classification of Diseases, Ninth Revision, codes for illicit drug abuse and endocarditis, bacteremia or sepsis, osteomyelitis and skin and soft tissue infections (SSTIs). 349 IDUs were identified for chart abstraction and 92% were either uninsured or had publicly funded insurance. SSTIs, the most common infection, were reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients (4.9%) died during their hospitalization. The total cost for treatment for injection drug use-related infections to Jackson Memorial Hospital over the 12-month period was $11.4 million. Conclusions: Injection drug use-related bacterial infections represent a significant morbidity for IDUs in Miami-Dade County and a substantial financial cost to the county hospital. Strategies aimed at reducing risk of infections associated with injection drug use could decrease morbidity and the cost associated with these common, yet preventable infections.
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U2 - 10.1371/journal.pone.0129360
DO - 10.1371/journal.pone.0129360
M3 - Article
C2 - 26075888
AN - SCOPUS:84937047376
VL - 10
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 6
M1 - e0129360
ER -
