Premier Inc. analysis: Hospital-associated sepsis decreased by 15% from 2015-2018
An analysis by Premier Inc. found that its member hospitals achieved a 15 percent decline in the incidence of hospital-associated sepsis over the last three years. However, patients who develop sepsis in the hospital are becoming sicker, and the average cost of these cases has increased by more than 20 percent.
Premier published the analysis in its latest data-driven report, Margin of Excellence: Lowering the Incidence and Severity of Hospital-Associated Sepsis, which highlights the major opportunities to treat sepsis in the hospital and reduce its frequency and severity. According to Premier discharge data from approximately 870 hospitals, hospital-associated sepsis as a percentage of all sepsis cases decreased by 15 percent from September 2015 to October 2018. Findings also show mortality rates for all sepsis patients dropped by 8 percent and readmission rates fell by 7 percent.
Over the course of nine years, approximately 350 participants in Premier’s quality improvement collaboratives reduced sepsis cases by more than 36 percent and sepsis mortality by more than 18 percent, generating lessons learned that can be leveraged by all acute-care members of Premier. While hospitals have made advancements, the Premier analysis also showed that during this timeframe, patients who developed sepsis in the hospital were 10 percent more likely to suffer from the most severe form of sepsis, known as septic shock. Meanwhile, the average cost per case for hospital-associated sepsis grew 20 percent to just over $70,000 – about seven times higher than the average cost per stay across all other conditions.
“While significant progress has been made, there is opportunity to reexamine protocols for patients who develop sepsis after being admitted for another medical reason, as this suggests a complication of care,” said Madeleine Biondolillo, MD, Vice President of Quality Innovation at Premier.
According to Premier data, 92.5 percent of those diagnosed with sepsis develop the infection in the community and that the average cost for present-on-admission sepsis cases has remained relatively flat at around $22,000 per case, most likely due to widespread efforts around early identification and treatment.
On the other hand, Premier’s findings show that the average cost per case for hospital-associated sepsis jumped more than 20 percent from approximately $58,000 in October 2015 to just over $70,000 in September 2018. This indicates that in 2018, hospitals in aggregate were spending an additional $1.5 billion to treat patients with hospital-associated sepsis compared to just three years prior.
Premier has identified four keys to successfully reduce the incidence and severity of sepsis cases (described in-depth in the report):
1. Leverage business intelligence with robust data and analytics capabilities to create targeted care delivery efforts that support clinical efficiency and improve quality for sepsis care across service lines.
2. Utilize clinician-enabling tools that support clinical surveillance and the delivery of evidence-based care, allowing for the proactive identification of patients who are at risk for hospital-associated infections and actionable decision-making at the point of care.
3. Optimize the lab and pharmacy with tests and formulations that enable rapid identification of sepsis as well as access to the appropriate therapies.
4. Promote a culture of care delivery optimization by championing collaboration and sustainability to connect the dots between quality improvement, cost reduction and patient outcomes.
