The DOI matches its Crossref record; 40 of the 41 references it cites were found in a registry or an index; 3 of the 11 sources its claims cite were checked for support.
Estimation of Direct Healthcare Costs of Fungal Diseases in the United States
Open accessAbstract
Background: Fungal diseases range from relatively minor superficial and mucosal infections to severe, life-threatening systemic infections. Delayed diagnosis and treatment can lead to poor patient outcomes and high medical costs. The overall burden of fungal diseases in the United States is challenging to quantify because they are likely substantially underdiagnosed. Methods: To estimate total national direct medical costs associated with fungal diseases from a healthcare payer perspective, we used insurance claims data from the Truven Health MarketScan® 2014 Research Databases, combined with hospital discharge data from the 2014 Healthcare Cost and Utilization Project National Inpatient Sample and outpatient visit data from the 2005–2014 National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. All costs were adjusted to 2017 dollars. Results: We estimate that fungal diseases cost more than $7.2 billion in 2017, including $4.5 billion from 75,055 hospitalizations and $2.6 billion from 8,993,230 outpatient visits. Hospitalizations for Candida infections (n=26,735, total cost $1.4 billion) and Aspergillus infections (n=14,820, total cost $1.2 billion) accounted for the highest total hospitalization costs of any disease. Over half of outpatient visits were for dermatophyte infections (4,981,444 visits, total cost $802 million), and 3,639,037 visits occurred for non-invasive candidiasis (total cost $1.6 billion). Conclusions: Fungal diseas…
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Claims the paper makes
25 Own result · 9 Own interpretation · 3 No full text of the sources · 2 Own method · 1 Supported · 1 Partly supported · 1 Sources not found · 1 Not checked yet · accuracy not yet measured
Every source the paper cites for this claim was checked and supports it.
In the paper
“For example, studies of autopsy reports suggest that only 50% of invasive fungal diseases are diagnosed before death [25].”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
What the sources say
- Supportedcites [25] Dignani, 2014, Epidemiology of invasive fungal diseases on the basis of autopsy reports, F1000Prime Rep source
The Pre-mortem diagnosis section reports a median of 46 diagnoses per 100 autopsies with invasive fungal disease. The Conclusions describe this as missing the diagnosis in around half of cases, supporting the citing sentence’s approximate 50% figure. (LLM, conf=0.94)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Other studies also support our findings that mucormycosis, though a rare disease, consistently results in high average hospitalization costs (>$100,000 in this study) due to its severity and long length of stay [10, 22].”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
What the sources say
- Supportedcites [10] Zilberberg, 2014, Hospital days, hospitalization costs, and inpatient mortality among patients with mucormycosis: a retrospective analysis of US hospital discharge data, BMC Infect Dis source
The Hospitalization outcomes section reports substantially higher average costs, longer stays, and higher mortality for mucormycosis cases than matched non-cases; the differences persisted across the eight-year study period. The parenthetical “>$100,000 in this study” describes the citing authors’ own finding, not a figure attributed to this source. (LLM, conf=0.89)
- Partly supportedcites [22] Kontoyiannis, 2016, Prevalence, clinical and economic burden of mucormycosis-related hospitalizations in the United States: a retrospective study, BMC Infect Dis sourceExperimental — accuracy not yet measured
The Discussion reports an average cost of $112,419 per mucormycosis-related hospital stay and describes substantial morbidity and mortality. It says prolonged stays, intensive care use, and severe underlying conditions *could* contribute to the high cost; the citing sentence states the cause more definitively. (LLM, conf=0.85)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Dermatophyte infections had the lowest average visit costs ($123–$217), and costs for vaginal candidiasis were also relatively low ($186–$287).”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Average cost per hospitalization varied by payment source, but were generally highest for mucormycosis ($106,655–$112,849), invasive candidiasis ($64,723–$153,090), and uncommon and opportunistic mycoses ($49,463–$131,823) (Table 2).”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of those, 1,354,331 visits (37%) were for vaginal candidiasis (total cost $368 million), 782,522 visits (22%) were for oral candidiasis (total cost $335 million), and 792,057 visits (22%) were for candidiasis of an unspecified site.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For all payment sources, the highest average visit costs were for mucormycosis ($1,382–$4,437) and esophageal candidiasis ($708–$1,812).”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Candida infections (26,735 hospitalizations, total cost $1.4 billion) and Aspergillus infections (14,820 hospitalizations, total cost $1.2 billion) accounted for the most hospitalizations and the highest total costs of any disease.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The total estimated cost of fungal disease hospitalizations was $4.6 billion”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Specifically, 84% of the total costs and 48% of the hospitalizations for Candida infections were due to invasive candidiasis.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Total outpatient costs for “other and unspecified mycoses” (n=204,780 visits) were $182 million.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plainn = 204,780- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
- It may state two separate claims as one. 16
- Probably not a substantial claim. 1
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of those, 1,354,331 visits (37%) were for vaginal candidiasis (total cost $368 million), 782,522 visits (22%) were for oral candidiasis (total cost $335 million), and 792,057 visits (22%) were for candidiasis of an unspecified site.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Candida infections (26,735 hospitalizations, total cost $1.4 billion) and Aspergillus infections (14,820 hospitalizations, total cost $1.2 billion) accounted for the most hospitalizations and the highest total costs of any disease.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of those, 1,354,331 visits (37%) were for vaginal candidiasis (total cost $368 million), 782,522 visits (22%) were for oral candidiasis (total cost $335 million), and 792,057 visits (22%) were for candidiasis of an unspecified site.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Candida infections (26,735 hospitalizations, total cost $1.4 billion) and Aspergillus infections (14,820 hospitalizations, total cost $1.2 billion) accounted for the most hospitalizations and the highest total costs of any disease.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Over half of all outpatient visits were for dermatophyte infections (4,981,444 visits), resulting in a national cost of $821 million.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“3,639,037 outpatient visits occurred for non-invasive candidiasis at a total cost of nearly $2.1 billion.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“compared with nearly $1 billion and 5.3 million average yearly visits for these two groups of infections in this analysis.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These superficial fungal infections were associated with >8 million national outpatient visits and $2.4 billion in costs.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We also observed a remarkable number of visits and high associated costs for “other and unspecified mycoses” (ICD-9-CM code 117.9)”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
In the paper
“Our findings suggest that fungal diseases have direct medical costs of more than $7 billion annually, approximately 0.22% of the total national health expenditures of $3.3 trillion in 2016 (the most recent year of data available) [18].”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
What the sources say
- Not matchedcites [18] Centers for Medicare & Medicaid Services
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Other studies have found that ICD-9-CM codes for aspergillosis and candidemia have only modest sensitivity and sometimes poor positive predictive values [26–28].”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
What the sources say
- Not checked yetcites [26] Asti L , NewlandJ, ZerrD, et al Multi-center validation of ICD-9 codes for candidemia in a pediatric population. In: Program and abstracts of the 48th Annual Meeting of the Infectious Diseases Society of America, Vancouver, 2010; poster number: 561. Available at: https://idsa.confex.com/idsa/2010/webprogram/Paper2463.html
- Not checked — no full text of the sourcecites [27] Chang, 2008, Comparison of the use of administrative data and an active system for surveillance of invasive aspergillosis, Infect Control Hosp Epidemiol source
- Not checked — no full text of the sourcecites [28] Schneeweiss, 2007, Veteran’s affairs hospital discharge databases coded serious bacterial infections accurately, J Clin Epidemiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The national cost of aspergillosis, candidiasis, cryptococcosis, and histoplasmosis in high-risk patients was previously estimated to be $2.6 billion in 1998, equivalent to $5.1 billion in 2017 [4].”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
What the sources say
- Not checked — no full text of the sourcecites [4] Wilson, 2002, The direct cost and incidence of systemic fungal infections, Value Health source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients at risk for these severe fungal diseases often have underlying conditions that can require additional healthcare expenditures, which are captured in our analysis if billed in the same outpatient visit or hospitalization with a fungal disease, and would inflate these estimates.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
In the paper
“The overall burden of fungal diseases in the United States is unknown and is difficult to quantify because they are likely substantially underdiagnosed, and no national public health surveillance exists for most fungal diseases [1].”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Introduction
What the sources say
- Not checked — no full text of the sourcecites [1] Vallabhaneni, 2016, The global burden of fungal diseases, Infect Dis Clin North Am source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because HCUP and NAMCS/NHAMCS cannot identify unique patients, our analysis captures prevalent rather than incident disease and therefore represents a snapshot of yearly costs rather than average costs incurred during a patient’s entire illness episode.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Lesser-known diseases like invasive candidiasis and aspergillosis affect a much smaller number of people (~15,000 hospitalizations in this analysis) but result in similarly large national costs because of their severity.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“In general, these indirect costs have not been well-established for most fungal diseases, but several studies document the negative impacts of certain diseases on patients’ quality of life [29, 30].”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
What the sources say
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Average costs per hospitalization and outpatient visit derived from the MarketScan databases are representative of national average costs for the corresponding payer groups.
“We used the Truven Health MarketScan® 2014 Research Databases to obtain the average cost per hospitalization and outpatient visit among patients with private insurance, Medicare supplemental insurance, and Medicaid.”
“To estimate total national costs by disease from a healthcare payer perspective, we multiplied the average cost per hospitalization and outpatient visit from MarketScan by the corresponding proportion of payers and the total number of hospitalizations and outpatient visits in the HCUP NIS and NAMCS/NHAMCS, respectively.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source doesn’t support the claim as written.
In the citing paper
“more than 1.5 times that of the costs reported 4 years prior [26].”
From Prevalence and Healthcare Burden of Fungal Infections in the United States, 2018 (2022) · cites this paper as [26]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In a study from 2019, IC accounted for 12,770 US hospitalizations, with an average of 28 workdays lost per hospitalization.49”
From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [49]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“It has previously been reported that there were nearly 75 000 hospitalizations and a further 8.9 million outpatient visits attributable to fungal infections in 2014, resulting in at least $7.2 billion in healthcare costs [26].”
From Prevalence and Healthcare Burden of Fungal Infections in the United States, 2018 (2022) · cites this paper as [26]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“In the 4-year span from the 2014 HCUP dataset analyzed by Benedict et al [26] to the 2018 data analyzed here, the total direct costs (all primary and invasive infections; adjusted for inflation) of fungal infections in inpatient visits nearly doubled from 3.9 million to 6.7 million USD (Figure 2, Supplementary Table 1).”
From Prevalence and Healthcare Burden of Fungal Infections in the United States, 2018 (2022) · cites this paper as [26]
The cited source says what the claim attributes to it.
In the citing paper
“In the 4-year span since 2014 [26], the overall number of fungal infections deemed directly responsible for hospitalization, either listed as cause for admission or as having an invasive presentation of disease, moderately increased.”
From Prevalence and Healthcare Burden of Fungal Infections in the United States, 2018 (2022) · cites this paper as [26]
In the citing paper
“In contrast, ≈1,000 blastomycosis-associated hospitalizations occur nationwide (10,11)”
From Blastomycosis Surveillance in 5 States, United States, 1987–2018 (2021) · cites this paper as [11]
In the citing paper
“In the United States, the total annual insurer and out-of-pocket costs for outpatient VVC treatment was estimated at US$368 million for 2017 7”
From Clinical challenges in diagnosis and treatment of recurrent vulvovaginal candidiasis (2022) · cites this paper as [7]
In the citing paper
“However, superficial mucosal C. albicans infections pose a considerable threat in immunocompromised populations and the high morbidity and mortality associated with serious invasive Candida infections continues to burden our healthcare systems.72–74”
From Molecular and genetic basis of azole antifungal resistance in the opportunistic pathogenic fungus Candida albicans (2020) · cites this paper as [72]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Estimation of direct healthcare costs of fungal diseases in the United States > Abstract > Results:
“3,639,037 visits occurred for non-invasive candidiasis (total cost $1.6 billion)”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
“3,639,037 outpatient visits occurred for non-invasive candidiasis at a total cost of nearly $2.1 billion.”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Estimation of direct healthcare costs of fungal diseases in the United States > Abstract > Results:
“$2.6 billion from 8,993,230 outpatient visits”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
“Fungal disease outpatient visits cost an estimated $2.7 billion”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
“These superficial fungal infections were associated with >8 million national outpatient visits and $2.4 billion in costs.”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
“Over half of all outpatient visits were for dermatophyte infections (4,981,444 visits), resulting in a national cost of $821 million. 3,639,037 outpatient visits occurred for non-invasive candidiasis at a total cost of nearly $2.1 billion.”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Estimation of direct healthcare costs of fungal diseases in the United States > Abstract > Results:
“dermatophyte infections (4,981,444 visits, total cost $802 million)”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
“dermatophyte infections (4,981,444 visits), resulting in a national cost of $821 million”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Estimation of direct healthcare costs of fungal diseases in the United States > Abstract > Results:
“4,981,444 visits, total cost $802 million”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
“4,981,444 visits), resulting in a national cost of $821 million”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Estimation of direct healthcare costs of fungal diseases in the United States > Abstract > Results:
“including $4.5 billion from 75,055 hospitalizations”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
“The total estimated cost of fungal disease hospitalizations was $4.6 billion”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Estimation of direct healthcare costs of fungal diseases in the United States > Discussion
“Lesser-known diseases like invasive candidiasis and aspergillosis affect a much smaller number of people (~15,000 hospitalizations in this analysis)”
§ Estimation of direct healthcare costs of fungal diseases in the United States > Results
“Candida infections (26,735 hospitalizations, total cost $1.4 billion) and Aspergillus infections (14,820 hospitalizations, total cost $1.2 billion) accounted for the most hospitalizations and the highest total costs of any disease. Specifically, 84% of the total costs and 48% of the hospitalizations for Candida infections were due to invasive candidiasis.”
Citations
Cites
Patterson, T. F., Thompson, G. R., Denning, D. W., Fishman, J. A., Hadley, S., Herbrecht, R., Kontoyiannis, D. P., Marr, K. A., Morrison, V. A., Nguyen, M. H., et al. (2016) · Clinical Infectious Diseases · doi:10.1093/cid/ciw326 · Cited by 2,926
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Bickers (2006) · doi:10.1016/j.jaad.2006.05.048 · Cited by 741
Healthcare Cost and Utilization Project
(2008) · Encyclopedia of Epidemiology · doi:10.4135/9781412953948.n196 · Cited by 505
Powers, J. H., Guerrero, M. L., Leidy, N. K., Fairchok, M. P., Rosenberg, A., Hernández, A., Stringer, S. M., Schofield, C. M., Rodríguez‐Zulueta, P., Kim, K. K., et al. (2015) · BMC Infectious Diseases · doi:10.1186/s12879-015-1330-0 · Cited by 504
The direct cost and incidence of systemic fungal infections
Wilson, L. S., Reyes, C. M., Stolpman, M., Speckman, J., Allen, K., & Beney, J. (2002) · Value in Health · doi:10.1046/j.1524-4733.2002.51108.x · Cited by 374 · cited 1×
“, transplant, HIV/AIDS, and cancer) [3, 4].”
Epidemiology of cryptococcal meningitis in the US: 1997–2009
Pyrgos, V., Seitz, A. E., Steiner, C. A., Prevots, D. R., & Williamson, P. R. (2013) · PLoS ONE · doi:10.1371/journal.pone.0056269 · Cited by 309
Diagnosing invasive candidiasis
Clancy, C. J., & Nguyen, M. H. (2018) · Journal of Clinical Microbiology · doi:10.1128/jcm.01909-17 · Cited by 293 · cited 1×
“Early detection is especially important in patients at high risk for developing invasive fungal diseases; examples of existing strategies include galactomannan assay for aspergillosis and β-D-glucan and T2Candida for invasive candidiasis [34].”
BackgroundThe global burden of fungal diseases
Vallabhaneni, S., Mody, R. K., Walker, T., & Chiller, T. (2016) · Infectious Disease Clinics of North America · doi:10.1016/j.idc.2015.10.004 · Cited by 292 · cited 1×
“The overall burden of fungal diseases in the United States is unknown and is difficult to quantify because they are likely substantially underdiagnosed, and no national public health surveillance exists for most fungal diseases [1].”
BackgroundSelf-citation
Cited by
Sorted by citations
Aspergillus fumigatus and Aspergillosis in 2019
Latgé, J.-P., & Chamilos, G. (2019) · Clinical Microbiology Reviews · doi:10.1128/cmr.00140-18 · Cited by 1,400
Gan, B., Gaynord, J. S., Rowe, S. M., Deingruber, T., & Spring, D. R. (2021) · Chemical Society Reviews · doi:10.1039/d0cs00729c · Cited by 524
The rapid emergence of antifungal-resistant human-pathogenic fungi
Lockhart, S. R., Chowdhary, A., & Gold, J. A. W. (2023) · Nature Reviews Microbiology · doi:10.1038/s41579-023-00960-9 · Cited by 323
“It is the primary cause of invasive aspergillosis, an infection responsible for substantial morbidity (>14,000 annual US hospitalizations) and mortality (>1,200 annual US deaths) 82–84 and requiring treatment with systemic antifungal medications.”
BackgroundPrevalence and Healthcare Burden of Fungal Infections in the United States, 2018
Rayens, E., & Norris, K. A. (2022) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofab593 · Cited by 228
“In the 4-year span from the 2014 HCUP dataset analyzed by Benedict et al [26] to the 2018 data analyzed here, the total direct costs (all primary and invasive infections; adjusted for inflation) of fungal infections in inpatient visits nearly doubled from 3.”
BackgroundMethodInfluentialAntifungal Drug Resistance: An Emergent Health Threat
Vitiello, A., Ferrara, F., Boccellino, M., Ponzo, A., Cimmino, C., Comberiati, E., Zovi, A., Clemente, S., & Sabbatucci, M. (2023) · Biomedicines · doi:10.3390/biomedicines11041063 · Cited by 232
“2 billion in direct costs to the USA Healthcare System alone [50].”
Background
Metadata
- Authors
- Benedict, K., Jackson, B. R., Chiller, T., & Beer, K. D.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Benedict, Kaitlin
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-09-10
- Volume
- 68
- Issue
- 11
- Pages
- 1791-1797
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC6409199
- OpenAlex
- W2891999566
- Cited by
- 438
- References
- 41
- Citations by year
- 2026: 33 · 2025: 55 · 2024: 73 · 2023: 72 · 2022: 72 · 2021: 63 · 2020: 44 · 2019: 21 · 2018: 3
- FWCI
- 24.75
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- Locations
- Clinical Infectious Diseases (publishedVersion, public-domain)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Infectious Diseases › Fungal Infections and Studies
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- fungal diseases, direct healthcare costs, economic burden, hospital costs, outpatient visits, candidiasis, aspergillosis, dermatophytosis, underdiagnosis, Healthcare Cost and Utilization Project, National Ambulatory Medical Care Survey
- MeSH terms
- Hospitalization, Humans, Inpatients, Insurance Claim Review, Mycoses, Outpatients, United States, Health Care Costs, Cost of Illness, Health Care Surveys
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
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Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
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