Table 2.
Estimates of the annual prevalence and total cost (in US$) of hospitalizations for selected waterborne diseases in the USA
| Medicaid | Medicare | Commercial | Uninsured | Total | |
|---|---|---|---|---|---|
| PRIMARILY WATERBORNE | |||||
| Giardiasis | |||||
| Mean total cost/hospitalization | $3863 | $11 842 | $10 588 | — a | $9607 |
| Proportion of hospitalizations with type of insurance |
20% | 29% | 39% | 9% | |
| Number of hospitalizations/year | 716 | 1038 | 1397 | 306 | 3581 |
| Total hospitalization cost | $2 766 681 | $12 297 799 | $14 787 095 | — a | $34 401 449b |
| Cryptosporidiosis | |||||
| Mean total cost/hospitalization | $16 203 | $9361 | $20 073 | $16 797 | |
| Proportion of hospitalizations with type of insurance |
21% | 23% | 47% | 9% | |
| Number of hospitalizations/year | 572 | 627 | 1281 | 233 | 2725 |
| Total hospitalization cost | $9 272 167 | $5 867 007 | $25 708 495 | — a | $45 770 572b |
| Legionnaires’ disease | |||||
| Mean total cost/hospitalization | — c | $26 741 | $38 363 | — a | $33 366 |
| Proportion of hospitalizations with type of insurance |
8% | 43% | 39% | 6% | |
| Number of hospitalizations/year | 1040 | 5590 | 5070 | 795 | 13 000 |
| Total hospitalization cost | — c | $149 482 190 | $194 500 410 | — a | $433 752 020b |
| Otitis externa | |||||
| Mean total cost/hospitalization | $4741 | $7903 | $5910 | — a | $6293 |
| Proportion of hospitalizations with type of insurance |
15% | 28% | 45% | 7% | |
| Number of hospitalizations/year | 664 | 1239 | 1992 | 316 | 4426 |
| Total hospitalization cost | $3 147 550 | $9 794 030 | $11 770 947 | — a | $27 851 446 |
| NTM infection | |||||
| Mean total cost/hospitalization | $21 041 | $20 787 | $38 432 | — a | $25 985 |
| Proportion of hospitalizations with type of insurance |
22% | 48% | 21% | 5% | |
| Number of hospitalizations/year | 3679 | 7933 | 3416 | 750 | 16 386 |
| Total hospitalization cost | $77 402 622 | $164 909 131 | $131 270 710 | — a | $425 788 469b |
| Pulmonary NTM infection d | |||||
| Mean total cost/hospitalization | $12 725 | $23 402 | $37 579 | — a | $25 409 |
| Proportion of hospitalizations | 16% | 57% | 20% | 4% | |
| Number of hospitalizations/year | 1248 | 4386 | 1510 | 290 | 7659 |
| Total hospitalization cost | $15 885 069 | $102 632 748 | $56 753 918 | — a | $194 597 422b |
| Disseminated NTM infection d | |||||
| Mean total cost/hospitalization | $21 080 | $12 310 | $47 123 | — a | $23 388 |
| Proportion of hospitalizations with type of insurance |
31% | 40% | 19% | 6% | |
| Number of hospitalizations/year | 2008 | 2573 | 1221 | 360 | 6447 |
| Total hospitalization cost | $42 337 221 | $31 675 113 | $57 535 633 | — a | $161 895 431b |
| Primarily waterborne total hospitalizations/year | 6671 | 16 428 | 13 155 | 2400 | 40 118 |
| Primarily waterborne total cost d | $92 589 019e | $342 350 156 | $378 037 657 | — a | $967 563 956b |
| PARTIALLY WATERBORNE | |||||
| Campylobacteriosis | |||||
| Mean total cost/hospitalization | $4328 | $7961 | $10 806 | — a | $8915 |
| Proportion of hospitalizations with type of insurance |
16% | 30% | 45% | 6% | |
| Number of hospitalizations/year | 2118 | 3972 | 5958 | 753 | 13 240 |
| Total hospitalization cost | $9 168 435 | $31 621 092 | $64 382 148 | — a | $118 048 105b |
| Salmonellosis | |||||
| Mean total cost/hospitalization | $4036 | $8605 | $8687 | — a | $7687 |
| Proportion of hospitalizations with type of insurance |
21% | 28% | 41% | 6% | |
| Number of hospitalizations/year | 4857 | 6476 | 9482 | 1426 | 23 128 |
| Total hospitalization cost | $19 602 368 | $55 724 603 | $82 374 304 | — a | $177 792 568b |
| Shigellosis | |||||
| Mean total cost/hospitalization | $3510 | $17 841 | $9675 | — a | $8721 |
| Proportion of hospitalizations with type of insurance |
38% | 17% | 32% | 10% | |
| Number of hospitalizations/year | 2087 | 933 | 1757 | 542 | 5491 |
| Total hospitalization cost | $7 323 896 | $16 654 038 | $17 000 136 | — a | $47 884 375b |
| Haemolytic uraemic syndrome | |||||
| Mean total cost/hospitalization | $29 968 | $42 803 | $63 605 | — a | $51 261 |
| Proportion of hospitalizations with type of insurance |
20% | 27% | 46% | 4% | |
| Number of hospitalizations/year | 475 | 641 | 1092 | 99 | 2373 |
| Total hospitalization cost | $14 222 813 | $27 424 310 | $69 429 946 | — a | $121 642 495b |
| Toxoplasmosis | |||||
| Mean total cost/hospitalization | $39 294 | $35 982 | $54 783 | — a | $44 705 |
| Proportion of hospitalizations with type of insurance |
42% | 19% | 17% | 14% | |
| Number of hospitalizations/year | 3733 | 1689 | 1511 | 1286 | 8889 |
| Total hospitalization cost | $146 699 434 | $60 770 360 | $82 784 235 | — a | $397 386 567b |
| Partially waterborne total hospitalizations/year | 13 270 | 13 711 | 19 800 | 4106 53 | 121 |
| Partially waterborne total cost | $197 016 945 | $192 194 403 | $315 970 768 | — a | $862 754 111b |
NTM, Non-tuberculous mycobacteria.
Data sources : 2006–2007 Nationwide Inpatient Sample; Marketscan 2004–2005 Multistate Medicaid and 2006–2007 Medicare Supplemental and Commercial Claims databases. All costs in 2007 US dollars.
a
Costs for uninsured patients could not be estimated from the insurance claims-based Marketscan databases.
b
Totals are higher than the sum of Medicaid, Medicare, and Commercial columns because the total includes the uninsured and other insurance sources (e.g. Tricare).
c
The number of cases of Legionnaires’ disease in the Marketscan Medicaid database was too small (<5 cases) to calculate cost estimates.
d
Pulmonary and disseminated NTM infections were a subset of all NTM infections and are not included in total cost calculations.
e
Not including Legionnaires’ disease costs.