Treating Children for Sepsis: Costs Soaring

Hospital stays are expensive, particularly when they involve advanced care and stays in the intensive care unit (ICU). People with severe sepsis and septic shock fall into this category. And when children are involved, costs can skyrocket because their care is so specialized. According to a research letter published in the August 2019 issue of JAMA Pediatrics, treating severe sepsis in children in the United States cost $7.31 billion in 2016 alone, up significantly from the estimated $4.8 billion it cost in 2005. The 2016 amount is 12 times the median cost of all other hospitalizations for children, including for treating cancers and traumas.

Sepsis is your body’s toxic response to an infection. Your body’s immune system goes into action to fight infections, but for unknown reasons, sometimes the immune system goes into overdrive and begins to attack the body itself instead of the infection that triggered the immune response in the first place. If sepsis is recognized and caught early, it can usually be treated effectively with fluids and antibiotics. Successful treatment reduces the chances of any lingering effects and overall treatment costs. Delays in diagnosis can result in sepsis progressing to severe sepsis. This occurs when one or more of your organs is affected, such as your heart, kidneys, lungs, even your brain. Severe sepsis progresses to septic shock if your blood pressure drops in addition to organ dysfunction. The progression can be very quick.

Children Get Sepsis Too

Very young children are at higher risk of developing sepsis than older children, but it can affect any child of any age, regardless of how healthy they were before they contracted the infection that led to sepsis. Each year, more than 75,000 children in the U.S. are diagnosed with severe sepsis; 9% die – an average of 18 per day. Almost 70% of children who are admitted to the hospital for sepsis are already dealing with other chronic health issues – and more than 20% of children who survive sepsis are readmitted to the hospital for sepsis-related issues within three months of their initial discharge, one-third within two weeks.

Treating Pediatric Sepsis Is Costly

According to the JAMA Pediatrics study, the median cost for a child’s sepsis hospitalization overall is $26,592. This comes out to a median of $36,332 for children with chronic conditions and $10,963 for children without an existing chronic condition. Over the course of a year, total cost of newborn hospitalizations for sepsis was an estimated $1.96 billion compared with $5.4 billion among older infants and children.

The average length of stay for sepsis patients is 31.5 days, which is nearly eight times longer than the average stay for other childhood conditions.  In another study published in 2019, in the journal Hospital Pediatrics, the researchers found the average cost per child who was rehospitalized after being treated in the hospital for sepsis was about $7,385. This is 27% higher than the costs for a readmission not related to sepsis.

JAMA Study Only Looks at Acute Care Hospital Costs

It’s important to understand that the costs described in the JAMA study are only direct hospital costs related to the initial admission and treatment of a child with sepsis. They do not include the costs of lost wages for parents or guardians, nor costs for living expenses if the children are in hospitals far from home. The amounts also don’t include the after-discharge costs that may occur, such as for rehabilitation (in-patient or out-patient), post-sepsis treatments, follow-up appointments, and any special equipment or adaptations that may be necessary, particularly if the child has undergone amputations.

Sepsis is expensive. The earlier it is diagnosed, the higher the chances of successful treatment at lower costs. For this reason, Sepsis Alliance encourages all members of the public to learn the memory aid, TIME™.

 

 

And more specifically for children:

To read stories about children who had sepsis and some tributes from parents who lost children to sepsis, visit Faces of Sepsis.

 

 

References:

 

Carlton EF, Barbaro RP, Iwashyna TJ, Prescott HC. Cost of Pediatric Severe Sepsis Hospitalizations. JAMA Pediatr. Published online August 12, 2019. doi:10.1001/jamapediatrics.2019.2570 https://jamanetwork.com/journals/jamapediatrics/article-abstract/2748380

Hartman ME, Linde-Zwirble WT, Angus DC, Watson RS. Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med. 2013;14(7):686-693. https://www.ncbi.nlm.nih.gov/pubmed/23897242

Prout AJ, Talisa VB, Carcillo JA, Mayr FB, Angus DC, Seymour CW, et al. Children with Chronic Disease Bear the Highest Burden of Pediatric Sepsis. J Pediatr. 2018; 199:194-199. https://www.ncbi.nlm.nih.gov/pubmed/29753542

Prout AJ, Talisa VB, Carcillo JA, Angus DC, Chang CCH, Yende S. Epidemiology of Readmissions After Sepsis Hospitalization in Children. Hosp Pediatr. 2019;9(4):249-255. https://hosppeds.aappublications.org/content/early/2019/02/28/hpeds.2018-0175

Weiss AJ, Elixhauser A. Overview of Hospital Stays in the United States, 2012. Statistical Brief; Healthcare Costs and Utilization Project (HCUP). October 2014. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb180-Hospitalizations-United-States-2012.pdf