Sepsis cases and costs growing among Medicare patients

Feb. 17, 2020

U.S. hospitals saw a 40 percent increase in the rate of Medicare beneficiaries hospitalized with sepsis over the past seven years, and that surge in cases was not simply a result of an expanding Medicare population, according to a study by researchers at the Department of Health and Human Services, (HHS).

From 2012 through 2018, the U.S. saw a 22 percent increase in the Medicare enrollment rates but a 40 percent increase in the rate of sepsis-related hospital admissions among beneficiaries, according to the study, which appears in Critical Care Medicine.

The researchers also explored the impact of sepsis severity on health outcomes for Medicare beneficiaries. Despite declining mortality overall, 10 percent of patients with non-severe forms of sepsis died while in the hospital or within a week of discharge, and 60 percent with non-severe forms of sepsis died within three years.

Outcomes were worse among patients with the most severe form of sepsis known as septic shock. Forty percent of these patients died while in the hospital or within a week of being discharged, and 75 percent died within three years.

The risk of developing sepsis was greater for patients who had other chronic health conditions than for those who did not. If patients with multiple chronic conditions developed sepsis, their risk of death in the hospital and within three years after discharge was greater than for other patients.

The study also identified the high costs of treating sepsis. Although the inpatient costs of care per stay among Medicare beneficiaries decreased between 2012 and 2018, the increase in the number of patients with sepsis led to an estimated overall increase in Medicare spending from $27.7 billion in 2012 to more than $41.5 billion in 2018. These costs included spending for inpatient hospital admissions and subsequent skilled nursing facility care.

To conduct the study, the research team analyzed data from more than 9.5 million inpatient hospital admissions that occurred between 2012 and 2018. The analysis included claims made on behalf of beneficiaries enrolled in both traditional Medicare and Medicare Advantage plans.

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