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Sepsis Survival Rates, Costs Vary Greatly by Hospital

Cheryl Clark, for HealthLeaders Media, March 3, 2011

Sepsis affects about 750,000 patients each year in the U.S. and of these, 20% die from those infections.  But a report that looked at 167,000 septic patients at 309 hospitals found that enormous variation in survival rates and cost, and that higher-spending hospitals did not achieve better survival rates.

The report, from Baystate Medical Center in Springfield, MA, suggests that studying those hospitals with lower treatment costs but higher survival rates might provide clues that could improve care everywhere.

"When examining costs and mortality concurrently, 22 hospitals (7%) had both significantly lower-than-expected costs and lower-than-expected mortality rates, and 30 hospitals (10%) had both higher than expected costs and mortality rates," they wrote.  The study, by Tara Lagu, MD, and colleagues, was published this week in the Archives of Internal Medicine.

Their report is another in a series showing that there is little correlation between how much a hospital spends and the quality of patient outcomes, similar to conclusions from studies conducted by the Dartmouth Atlas and others.

Lagu and colleagues wrote that they tried to find the reasons for the variation in spending. "Higher-spending hospitals did not spend proportionately more on any specific service, such as pharmacy or diagnostic imaging," they wrote. "Furthermore while longer length of stay explained some of the difference across quintiles, the highest spending hospitals also had the highest costs per day."  Higher fixed costs, they continued, did not explain the spending patterns.

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