Volume 27, Number 1—January 2021
Research
Estimate of Burden and Direct Healthcare Cost of Infectious Waterborne Disease in the United States
, Li Deng, Elizabeth A. Adam, Katharine M. Benedict, Elizabeth M. Beshearse, Anna J. Blackstock, Beau B. Bruce, Gordana Derado, Chris Edens, Kathleen E. Fullerton, Julia W. Gargano, Aimee L. Geissler, Aron J. Hall, Arie H. Havelaar, Vincent R. Hill, Robert M. Hoekstra, Sujan C. Reddy, Elaine Scallan, Erin K. Stokes, Jonathan S. Yoder, and Michael J. Beach
Table 4
Cost per hospital stay for selected diseases that can be transmitted by water, 2012–2013 IBM MarketScan health insurance databases, United States*
| Disease/syndrome | Cost in 2014 US dollars (95% CrI) |
|||
|---|---|---|---|---|
| Commercial insurance | Medicare | Medicaid | Overall | |
| Campylobacteriosis | 15,200 (1,520–47,100) | 15,100 (1,630–55,300) | 5,900 (85–29,000) | 13,600 (3,850–35,800) |
| Cryptosporidiosis | 17,900 (1,560–82,700) | 17,300 (1,800–79,400) | 10,700 (22–64,200) | 16,100 (4,360–55,400) |
| Giardiasis | 25,300 (1,790–168,000) | 22,300 (1,890–96,900) | 14,300 (159–88,000) | 21,800 (6,160–99,200) |
| Legionnaires’ disease | 45,900 (2,320–306,000) | 33,600 (4,210–183,000) | 18,700 (17–99,300) | 37,100 (7,950–149,000) |
| NTM infection | 44,100 (1,650–244,000) | 27,600 (1,720–152,000) | 14,800 (49–69,100) | 29,600 (6,350–120,000) |
| Norovirus infection† | 6,080 | |||
| Otitis externa | 13,800 (1,480–56,500) | 14,400 (1,490–65,100) | 6,680 (43–36,900) | 12,200 (3,320–42,400) |
| Pseudomonas pneumonia | 45,100 (1,510–193,000) | 28,200 (1,890–146,000) | 11,600 (18–53,200) | 29,300 (5,910–114,000) |
| Pseudomonas septicemia | 63,600 (1,450–386,000) | 34,400 (2,200–181,000) | 19,800 (47–113,000) | 38,200 (6,340–172,000) |
| Salmonellosis, nontyphoidal | 17,200 (2,010–73,600) | 17,100 (1,400–62,700) | 6,940 (70–26,300) | 14,900 (4,300–46,900) |
| STEC infection, serotype O157 | 25,900 (2,410–150,000) | 17,200 (1,860–82,200) | 4,530 (3–30,200) | 19,000 (3,790–85,000) |
| STEC infection, serotype non-O157 | 23,600 (1,390–95,700) | 31,900 (2,620–250,000) | 5,020 (458–32,000) | 24,200 (4,780–138,000) |
| Shigellosis | 19,000 (2,910–85,300) | 13,500 (1,610–39,600) | 7,710 (37–51,300) | 14,200 (4,130–48,000) |
| Vibrio spp. infection | 17,400 (2,260–50,500) | 18,400 (0,977–78,700) | 4,600 (13–46,000) | 16,000 (3,780–39,900) |
*Estimates rounded to 3 significant figures. Overall cost calculated using the sum of insurer and out-of-pocket payments per stay for each payment source multiplied by the proportion of persons in the Health Care Utilization Project’s Nationwide Inpatient Sample with each payment source, for the corresponding disease or syndrome. This produces a weighted average cost per stay that reflects the differing proportion of payment sources for each disease or syndrome. Persons who had a payment source other than commercial insurance, Medicare, or Medicaid (i.e., persons covered by Tricare (the healthcare plan for persons affiliated with the US armed services, who were uninsured, or who had an unknown source of insurance) were assumed to have a cost per stay equivalent to the commercial insurance cost per stay. NTM, nontuberculous mycobacterial; STEC, Shiga toxin–producing Escherichia coli. †Norovirus costs were derived from previously published estimates that did not specify cost per insurance source or include uncertainty intervals.