Waterborne Diseases Cost U.S. More Than $500 Million Each Year

Hospitalizations for three common waterborne diseases cost the U.S. health care system as much as $539 million annually, according to research presented Thursday at the International Conference on Emerging Infectious Diseases.

"These cost data highlight that water-related diseases pose not only a physical burden to the thousands of people sickened by them each year, but also a substantial burden in health care costs, including direct government payments through Medicare and Medicaid," said Michael Beach of the Centers for Disease Control and Prevention, an author of the study.

Currently, there are no well-documented data on the total health care costs associated with all waterborne diseases. However, using data from a large insurance claims database between 2004 and 2007, Beach and his colleagues estimated the hospitalization cost of three common waterborne diseases in the United States: Legionnaires' disease, cryptosporidiosis and giardiasis. For each case of disease, they calculated the cost paid by the insurer, the out-of-pocket cost to the patient, and the total amount paid.

Total estimated costs for hospitalization for the three diseases were $154-539 million, including $44-147 million in direct government payments for Medicare and Medicaid. Estimated annual costs for the individual diseases were: giardiasis, $16-63 million; cryptosporidiosis, $37-145 million; and Legionnaires' disease, $101-321 million.

Inpatient hospitalization costs per case averaged more than $34,000 for Legionnaires' disease, approximately $9,000 for giardiasis, and more than $21,000 for cryptosporidiosis.

"When people think about these diseases, they usually think of a simple case of diarrhea, which is a nuisance but quickly goes away,” Beach said. “However, these infections can cause severe illness that often result in hospital stays of more than a week, which can quickly drive up health care costs.”

Other symptoms can include rashes, eye and ear infections and respiratory or neurological symptoms and can even be fatal.

Modest investments in preventing these diseases could lead to reduced disease and significant health care cost savings, Beach said. Some examples of possible, low-cost interventions include public education campaigns, appropriate maintenance of building water systems, and regular inspection of pools and other recreational water facilities.

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