TABLE 4: Pre/Post Sepsis Protocol Cost Impact
Quality adjusted life years (QALY) provides an economic evaluation of an intervention. For sepsis, a recent study by Higgins et al and Wilcox et al determined a favorable lower cost with greater effectiveness for a number of the sepsis bundle elements. Unfortunately, many of the bundle elements remain without economic evaluations. Key to point out is the favorable cost effectiveness of a multi-disciplinary, coordinated quality improvement sepsis program to improve bundle compliance as well as ICU admission for the management of sepsis and septic shock.
Wilcox ME, et al Crit Care Med 2019:47:1011-1017
Higgins AM, et al J Intensive Care 2020; https://doi.org/10.1186/s40560-019-0412-2
Given the high burden sepsis places on individuals and the care delivery system, a high quality understanding of disease interventions and outcome are needed to better understand the most cost effective clinical interventions. The current literature provides little insight with considerable heterogeneity on financial sepsis results.
However, we can conclude:
- The best sepsis outcomes and cost considerations are when sepsis is identified early and with effective treatment.
- Sepsis which progresses to its severest form or identified after admission (due to either a missed identification or complication) has the lowest clinical effectiveness with the highest costs.