Which Condition Ranks Highest for Hospital Readmission?
Of the medical conditions tracked by the government to measure quality of care and guide pay-per-performance reimbursements, sepsis accounted for significantly more hospital readmissions and associated costs than any of the tracked conditions. Findings from the analysis are published in the Journal of the American Medical Association.
Currently, the Centers for Medicare & Medicaid Services (CMS) tracks readmission rates for heart attack, heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia. Hospitals are penalized if they demonstrate excessive rates of readmissions for these conditions.
Sachin Yende, MD, MS, associate professor in the Pitt School of Medicine's departments of Critical Care Medicine and Clinical and Translational Sciences, and colleagues analyzed data from the 2013 Nationwide Readmissions Database for the four conditions and sepsis; this database makes up 49% of inpatients in the United States. They found that sepsis accounted for 12.2% of readmissions, heart failure for 6.7%, pneumonia, 5%, COPD, 4.6%, and heart attack, 1.3%. In addition, sepsis proved to be a more costly readmission with an estimated average cost of $10,070 per readmission vs. $9,424 for heart attack, $9,051 for heart failure, and $8,417 for COPD.
Sepsis can progress to septic shock and statistics show that about 28–50% of patients with sepsis do not survive. Dr. Yende explained, "[But] all research to date shows that sepsis has serious, lingering consequences, and patients continue to have problems well after they are discharged."
Study findings call for coordinated efforts to develop new medical interventions aimed at improving sepsis outcomes and decreasing admissions.
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