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Sepsis Remains Significant Challenge for Hospitals: Public Health Watch Weekly Report

Recently, research findings, government action, and global public health initiatives have focused new attention on an age-old problem—sepsis, and its related complications.
Sepsis, a diagnosis that dates to ancient Greece, remains a significant public health challenge. A meta-analysis published last year suggests there may be as many as 30 million new cases annually, resulting in more than 6 million deaths worldwide (although the authors admit that these may, in fact, be underestimates, given that they were unable to obtain data from poorer countries, where the vast majority of the world’s population lives). Here in the United States, septicemia is still one of the most common diagnoses which result in hospital stays. Data collected for the Healthcare Cost and Utilization Project (HCUP), and posted in June 2017, indicates that hospital stays related to septicemia increased from 518,000 in 2005 to 1.514 million in 2014 (accounting for 4.3% of hospital stays)—an increase of 192.3%.
Although HCUP reports that, overall, hospital stays declined 6.6% over the analysis period, septicemia now ranks third among the most common diagnoses leading to admissions, behind pregnancy and neonatal care. Interestingly, given the ongoing rhetoric surrounding the cost of healthcare in the 50 states, it is worth noting that the mean cost per hospital stay increased 12.7% from 2005 to 2014, according to HCUP. Although there is no specific data on the cost of hospital stays associated with septicemia, HCUP found that costs associated with “medical” hospitalizations increased 11.4% during the analysis period.
Meanwhile, the Global Sepsis Alliance (GSA) estimates that sepsis causes half of all hospital deaths in the United States, and that the disease accounts for $24 billion in hospital costs.
With that in mind, the World Health Organization (WHO), during its most recent World Health Assembly in May 2017, approved a resolution calling for new efforts to improve the prevention, diagnosis, and management of sepsis. The resolution urges countries to implement national action plans to tackle sepsis; launch initiatives to improve access to clean water, sanitation, and hygiene to reduce the number of new cases; continue efforts to combat antimicrobial resistance (via stewardship) in order to help improve sepsis treatment outcomes; and to work with professional societies to develop guidelines on the diagnosis and management of sepsis. The resolution also calls for WHO to publish epidemiologic data on sepsis and release treatment protocols.

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