A Cost Analysis of Hospitalizations for Infections Related to Injection Drug Use at a County Safety-Net Hospital in Miami, Florida

PLoS One. 2015 Jun 15;10(6):e0129360. doi: 10.1371/journal.pone.0129360. eCollection 2015.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Costs and Cost Analysis*
  • Drug Users*
  • Female
  • Florida
  • Hospitalization*
  • Humans
  • Infections / diagnosis
  • Infections / epidemiology*
  • Infections / etiology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Safety-net Providers*
  • Substance Abuse, Intravenous / complications
  • Young Adult

Grants and funding

This work was supported by the Infectious Diseases Society of America Medical Scholars Program to HT SD, (http://www.idsociety.org/Medical_Scholars_Program/) and the Jackson Memorial Hospital Department of Internal Medicine Resident Scholarly Activity Program to HT. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.