Sepsis cost, mortality higher in teaching hospitals
ORLANDO, Fla. — New data presented here suggest that teaching hospitals, when compared with non-teaching hospitals, provided care for children with sepsis at a greater cost without improving mortality rates.
Researchers noted that US teaching hospitals face increasing pressure to provide cost-effective health care in addition to medical education. "For pediatric patients, the diagnosis of sepsis has carried a high mortality and morbidity along with annual costs greater than $2 billion," they wrote.
Benson Hsu, MD, MBA, FAAP, of Sanford School of Medicine, and colleagues investigated the impact of teaching hospital status on pediatric patients with a diagnosis of sepsis in terms of financial cost, the use of resources and mortality. The researchers used data from the Agency for Healthcare Research and Quality 2009 Kids' Inpatient Database, which included 7,370,203 weighted discharges in 4,121 hospitals over 44 states. Diagnoses of sepsis and illness severity in pediatric patients were validated using the All Patient Refined-Diagnostic Related Group (APR-DRG) 720: Septicemia and Disseminated Infections.
Results indicated that 11,893 patients were discharged with an APR-DRG 720 — 5,085 in non-teaching hospitals and 6,808 in teaching hospitals. Pediatric patients treated for sepsis at non-teaching hospitals had a mortality rate of 1.63% compared with 4.66% in teaching hospitals, an average length of stay of 4.86 days vs. 8.13 days, an average number of procedures of 0.89 vs. 2.04, and total hospitalization charges of $29,829 vs. $65,639 (P<.001 for all).
When the researchers examined only the highest severity of illness — 592 discharges in non-teaching hospitals vs. 2,034 in teaching hospitals — they found that patients admitted to non-teaching hospitals for sepsis had a mortality rate of 12.5% compared with 14.01% in teaching hospitals (P=.35), an average length of stay of 10.91 days vs. 14.19 days (P<.001), an average number of procedures of 3.31 vs. 4.3 (P<.001), and total hospitalization charges of $113,384 vs. $143,999 (P<.001).
"Our research indicates that teaching hospitals serve a vital purpose in educating the future generations of physicians," Hsu told Infectious Diseases in Children. "However, we need to recognize that this education may incur a cost in relationship to the charges a patient may face. Recognition of this may allow us to better structure how we finance health care education."
Benson Hsu, MD, MBA, FAAP can be reached at firstname.lastname@example.org.
For more information:
Hsu B. Abstract #22043. Presented at: AAP National Conference and Exposition; Oct. 26-29, 2013; Orlando, Florida.
Disclosure: The researchers report no relevant financial disclosures.