A January 22, 2017 JAMA article examined the readmission rate and costs of patients discharged with a diagnosis of sepsis. The study examined the 30-day readmission rates. Currently, CMS tracks readmissions following index hospitalizations for acute myocardial infarction (AMI), heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia
Although previously unstudied, the authors hypothesized that sepsis hospitalizations accounted for a higher percentage of unplanned 30-day readmissions than hospitalizations for AMI, heart failure, COPD, and pneumonia.Methods
Using 2013 CMS data, which included 14 325 172 hospitalizations and identified 1 187 697 that were associated with an unplanned 30-day readmission. Of those, 147 084 (12.2%; 95% CI, 11.9%-12.4%) had a diagnosis of sepsis, 15 001 (1.3%; 95% CI, 1.2%-1.3%) AMI, 79 480 (6.7%; 95% CI, 6.5%-6.8%) heart failure, 54 396 (4.6%; 95% CI, 4.5%-4.8%) COPD, and 59 378 (5.0%; 95% CI, 5.0%-5.3%) pneumonia.
Some overlapped as 1061 (0.7%) also had diagnostic codes that met CMS criteria for AMI, 5063 (3.4%) heart failure, 4829 (3.3%) COPD, and 11 093 (7.5%) pneumonia.The mean length of stay for unplanned readmissions following sepsis hospitalization was longer than readmissions following AMI, heart failure, COPD, and pneumonia (Table). The estimated mean cost per readmission was highest for sepsis compared with the other diagnoses ($10 070 [95% CI, $10 021-$10 119] for sepsis, $8417 [95% CI, $8355-$8480] for COPD, $9051 [95% CI, $8990-$9113] for heart failure, $9424 [95% CI, $9279-$9571] for AMI, and $9533 [95% CI, $9466-$9600] for pneumonia; P < .005 for all pairwise comparisons).