Higher Spending Does Not Improve Sepsis Outcomes

More than one-third of hospitals significantly exceed expected spending

WEDNESDAY, March 2 (HealthDay News) -- There is substantial variation in both hospital spending and mortality rates for patients with sepsis among hospitals, but higher levels of spending are not associated with improved survival, according to a study published in the Feb. 28 issue of the Archives of Internal Medicine.

Tara Lagu, M.D., M.P.H., of the Baystate Medical Center in Springfield, Mass., and colleagues investigated variations in hospital-level spending to determine whether there was an association with sepsis mortality rates. They examined 309 U.S. hospitals that treated a total of 166,931 patients with sepsis between 2004 and 2006.

The researchers found substantial variations in both hospital-level mortality and cost, but no significant association between hospital spending and mortality. Of 61 hospitals (19 percent) at the median expected mortality of 19.2 percent, observed mortality varied from 9 to 32 percent. Over one-third of hospitals (34 percent) surpassed expected costs by at least 10 percent, with a median average excess of $5,207. Twenty-two hospitals (7 percent) had both lower-than-expected costs and mortality rates.

"Hospital spending and adjusted mortality rates for patients with sepsis vary substantially, but higher hospital expenditures are not associated with better survival. Efforts to enhance the value of sepsis care could be modeled on hospitals that achieve lower-than-expected mortality and costs," the authors write.

One study author disclosed a financial relationship with Eli Lilly & Company, and another author reported financial ties with OptiStatim.

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