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According to the National Center for Biotechnology Information, sepsis is the most expensive in-patient cost in American hospitals. In 2017, there were 1.09 million cases of sepsis nationally with an average readmission rate of 15.8 percent based on Medicare claims data.
With September marking Sepsis Awareness Month, we leveraged Definitive Healthcare data to understand the national scope of the condition. The region with the highest number of sepsis cases was the Southeast, but fell in the mid-range for number of days spent in the hospital. Conversely, the Southwest has the lowest number of cases, but is not far behind the Southeast’s average length of stay.
Fig 1 Data from Definitive Healthcare’s Expert platform, featuring exclusive insights on the national healthcare market, based on most recent available Medicare data.
The distribution of sepsis patient volume shows a fairly normal distribution proportionate to state population. Most U.S. hospitals had fewer than 500 patients with sepsis, however, there were 221 hospitals with over 1,000 reported cases. On the high end, there are 10 hospitals that had about 2,200 or more sepsis patient admissions. Six of the top ten can be found in either the Southeast or Southwest region. This could be due to a variety of variables, such as larger populations of uninsured or underinsured patients or higher instances of sepsis-related complications.
According to Definitive Healthcare Data, here are the top 10 hospitals with the most patient admissions in 2017:
Fig 2 Data from Definitive Healthcare’s Hospitals and IDNs platform.
In 2015, the Center for Medicare and Medicaid Services adopted the Sepsis National Hospital Inpatient Quality Measure (SEP-1) to help address the high mortality and high cost associated with sepsis. With this initiative in place, health systems are getting better at combating sepsis and providers across the U.S. are continuing to do their part to improve sepsis awareness.
Huntsville Hospital, which falls in the region with the highest number of sepsis cases, implemented a sepsis improvement program. This particular Alabama hospital saw a reduction of sepsis mortality by more than 50 percent and a significant decrease in hospital readmissions, according to a study published in the Journal of the American Medical Informatics Association. According to Definitive Healthcare’s Medicare data, Huntsville Hospital reported approximately 550 cases of sepsis in 2018.
AdventHealth Orlando, the hospital with the most patient admissions for sepsis, has not yet implemented a specific program to prevent the infection, but it is taking significant action to improve the health system. This August, the hospital opened its own incident command center. With this in place, the hospital hopes to eventually be able to develop evidence-based protocols for the prevention and treatment of sepsis.
Initiatives such as Sepsis Awareness Month sponsored by the Sepsis Alliance and the CMS metric SEP-1, can certainly help ensure timely, consistent, and high-quality care for sepsis patients, but there is still more work to be done. To take the SEP-1 quality measure a step further, CMS has made this data publicly available for patients across the country to access via Medicare’s Hospital Compare website.
Given the dangers and costs of sepsis, CMS will likely continue to press this issue beyond public displays of hospital sepsis scores. Perhaps in the future, the SEP-1 measure will be included as part of the CMS infection measures program for hospitals along with CLABSI and surgical site infections. If that were to happen, low scores could negatively impact revenue, making the incentives to improve sepsis management even stronger.
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