There are considerable variation in the rates of sepsis and severe sepsis according to countries. At present, it is estimated that there are more than 1,000,000 cases of sepsis among hospitalized patients each year in the USA. Numerous reports have shown the incidence of sepsis and severe sepsis increasing in excess of the growth of the population. Sepsis is a major cause of mortality throughout the world, killing about 1.400 people every day; up to 135,000 European and 215,000 American deaths each year are reported from sepsis. In fact, the number of people dying from sepsis each year is similar to the number of people dying with acute myocardial infarction, and far exceeds those who die from HIV, breast cancer or stroke. In the USA, sepsis is the tenth leading cause of death overall.
With treatment costs greater than €20,000 per patient, about €10 billion in Europe and €17.4 billion in the US are spent annually for sepsis treatment. Healthcare expenditures for sepsis in the ICU are poorly predictable by patient characteristics, however, limiting the development of potential cost-saving strategies. New research gives insight as to how facilities can cut the rates for an illness with a high percentage of readmissions: sepsis. A study from the University of Michigan compared the readmission rates of patients diagnosed with sepsis to those who went to the hospital for various other acute illnesses. Thet made their findings using detailed data from 2,600 survivors of sepsis. After three months, the readmission rates for both groups stood at about 42%. But the patients with sepsis were more likely to be readmitted due to conditions that could’ve been prevented with the proper follow-up care. Patients who had survived sepsis were significantly more likely to get readmitted for a condition that could possibly have been prevented or treated early to avoid a hospital stay. They were especially more likely to end up back in the hospital due to a second bout of sepsis, or kidney or lung failure. They also had more hospitalizations linked to infections, including in the lungs, skin and soft tissue as well as systemic sepsis. Nearly half of those readmissions were due to illnesses that are not on the usual list of ambulatory care sensitive conditions. In US Hospitals currently face financial penalties from Medicare if too many of their heart failure or pneumonia patients get readmitted within 30 days of discharge. However, authors concluded: “Let’s stop arguing about whether better inpatient care could prevent all readmissions, and instead focus on building better systems to insure patients get the post-discharge care they need”. Getting on the right medications and diet, receiving counseling on infection risks and signs, and having kidney function tested more often could be examples of post-hospital interventions that sepsis survivors could benefit more from. These data argue that combining precision medicine with primary care physicians and their teams could offer real benefits for patients, families and health systems.