Sepsis Core Measures – Are They Worth the Cost?

Publication date: Available online 22 September 2018

Source: The Journal of Emergency Medicine

Author(s): Amanda Esposito, Michael E. Silverman, Frank Diaz, Frederick Fiesseler, Gita Magnes, David Salo

Abstract

Background

In 2015, the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission launched the sepsis core measures in an attempt to decrease sepsis morbidity and mortality. Recent studies call into question the multiple treatment measures in early goal-directed therapy on which these CMS measures are based.

Objectives

The purpose of this study is to compare the utilization of resources due to the implementation of the sepsis core measures while examining whether complying with these treatment guidelines decreases patient mortality.

Methods

Data were collected on patients suspected of sepsis in a suburban academic emergency department. These data were collected over the course of 3 consecutive years. The data collected included lactates, blood cultures, and antibiotics (vancomycin, piperacillin/tazobactam) ordered. The mortality rate of patients with a final diagnosis of sepsis present on arrival was calculated for a 3-month period of each year and compared.

Results

There was no difference in the mortality rates of patients with sepsis across the 3 years. There was an increase in the amount of piperacillin/tazobactam and vancomycin administered. There was a significant increase in the number of lactates and blood cultures ordered per patient across all 3 years.

Conclusions

There was no difference in the mortality rate of patients with a final diagnosis of sepsis. However, there was a significant increase in the utilization of resources to care for these patients. As a result of the overutilization of these resources, the cost for both patients and hospitals has increased without improvement in mortality.

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