The Impact of Severe Sepsis
The true institutional impact of severe sepsis is difficult to evaluate. Before 2002, there were no administrative codes (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] diagnostic codes) or diagnosis-related groups (DRGs) specific to the disease. Despite the establishment of an ICD-9-CM code for severe sepsis (995.92) and septic shock (785.52), severe sepsis patients remain spread across more than 300 DRGs.1
Severe Sepsis is Common, Deadly and Costly
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This presentation demonstrates that severe sepsis should be an institutional priority due to its impact on patient mortality, quality initiatives and finances in medical institutions.
Tracking severe sepsis
The impact of severe sepsis on institutions is often hidden among underlying diagnoses. But the cost of treating patients with the disease is significant. Patients with severe sepsis have:
- Higher total hospital costs — nearly twice those of other patients1†‡
- Lower payment-to-cost ratios — 72% of cases are under-reimbursed and severe sepsis patients are five times as likely to be outliers1†‡
Rising costs
Severe sepsis consumes an increasing share of resources. This has a major impact on healthcare institutions. Treating severe sepsis significantly increases the cost of patient care, and reimbursement mechanisms do not adequately reflect those increased costs.
Challenging care
A recent analysis of the top 10 DRGs which covered 70% of all severe sepsis cases revealed that the mortality rate of ICU patients with severe sepsis was more than 4 times that of patients without severe sepsis.†‡ Patients with severe sepsis had:
- Increased ventilator use — 15 times higher than other patients†‡
- Longer lengths of stay†‡
*Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29(7):1303-1310.
†Severe sepsis patients were identified by looking for combinations of ICD-9-CM codes indicating infection and new onset of acute organ failure following SCCM/ACCP guidelines as described in Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29(7):1303-1310.
‡All analyses were performed using the 2004 through 2005 MEDPAR Hospital Discharge Database. Cost and charge data are reported in year-appropriate U.S. Dollars. The information presented represents national averages and similar analyses performed at an institution may provide different results.
Reference:
- Data on file, Eli Lilly and Company: XIG20070405a.
