Caseload, treatment diagnoses, and evaluation of clinical care concepts for infectious diseases at a municipal tertiary care hospital in Germany

BACKGROUND: Comprehensive data on municipal specialized infectious disease (ID) departments in Germany are scarce. PURPOSE: To analyze ID cases at Hospital St. Georg in Leipzig with regard to patient characteristics, spectrum of infections, care concepts, length of stay (LOS), clinical outcomes, and economic indicators. METHODS: Retrospective descriptive analysis of all adult inpatient cases between January 2020 and December 2025. RESULTS: Of 17,878 adult patients (11.5% of all patients) discharged with a primary ID diagnosis, 28.7% (5,135/17,878) were treated as inpatients in the 40-bed ID department itself, while 3.8% (671/17,878) received organ-specific treatment in another specialty department with concurrent care provided by the antimicrobial stewardship (AMS) team, and 5.2% (935/17,878) received care via the ID consultation service (telephone consultations not included). A total of 4,492 individual ICD-10 codes were assigned, with 740 of them being classified as ID diagnoses. ID patients were older (median 70 vs. 66 years) and more frequently male (59% vs. 51%) than the reference population. The median LOS was longer for ID patients (7.0 vs. 4.1 days). The median case-mix index (CMI) was 1.344 (€ 5,356 per case) in the ID population vs. 1.113 (€ 4,352 per case) in the reference group. CONCLUSIONS: This six-year analysis shows that ID patients represent a significant, complex, and older inpatient population with longer LOS, causing high clinical burden. Since coding data suggest that 62.3% of these patients did not receive specific treatment by ID specialists, there is potential for expanding structured ID consultation and AMS services, requiring additional resources.