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 Sepsis Causes More Hospital Readmissions than Conditions CMS Tracks

University of Pittsburgh Medical Center and VA Pittsburgh Healthcare System researchers found that sepsis is the reason more Medicare beneficiaries are readmitted to hospitals than for the conditions the Centers for Medicare & Medicaid Services (CMS) measures under the Hospital Readmissions Reduction Program.
Sepsis is a life-threatening condition caused by a body’s reaction to an infection.
Researchers said the sepsis 30-day readmission rate of 12.2 percent topped those for acute myocardial infarction (AMI) at 1.2 percent, heart failure at 6.7 percent, chronic obstructive pulmonary disease (COPD) at 4.6 percent, and pneumonia at 5.2 percent. These four conditions, and not sepsis, are the CMS benchmarks for its pay-for-performance program.
“We hypothesized that sepsis hospitalizations account for a higher proportion of unplanned 30-day readmissions than hospitalizations for AMI, heart failure, COPD, and pneumonia in the United States,” according to the report, which recently appeared in the Journal of the American Medical Association.
Florian Mayr, MD, lead author of the report and a faculty member at the University of Pittsburgh’s Department of Critical Care Medicine, says the investigation stemmed from an interest among clinicians in what other conditions, like sepsis, caused readmissions versus the currently tracked illnesses. He said it is important for the provider community and CMS to realize that readmissions associated with sepsis were on average lengthier and costlier than the other conditions.
The average cost per patient with sepsis was found to be $10,070, versus between $8,417 and $9,533 for the other conditions. The length of stay average topped seven days for those suffering from sepsis, while the four measured illnesses ranged from 5.7 to 6.7 days on average. “So, the two big points are that sepsis has the highest proportion of readmissions and is longer and costlier,” Mayr says.
From a clinician standpoint, he says, there was not a lot of surprise from the findings “based on how frequently we see sepsis in the hospital, particularly in the ICU…it is a heavy hitter.” But a wrinkle found in the research should be a warning to acute-care and post-acute care hospitals and the long term care community in general.
“When you develop sepsis, go to the ICU, get better, and go home, with a third of patients going to skilled nursing facilities, everyone thinks it’s done, But the truth is, it is not done. Patients who survive sepsis have a high risk of getting it again. There is a high risk of death one to three years from the initial sepsis incident,” Mayr says.
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