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Increased healthcare facility use in veterans surviving sepsis hospitalization
Kimberley M DeMerle1, Brenda M Vincent2, Theodore J Iwashyna3
1Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
Purpose:
We sought to measure inpatient healthcare utilization among U.S. Veteran Affairs beneficiaries surviving sepsis hospitalization, and to examine how post-sepsis utilization varies by select patient characteristics.
Materials And Methods:
Retrospective cohort study of 26,561 Veterans who survived sepsis hospitalization in 2009. Using difference-in-differences analysis, we compared changes in healthcare utilization in one year before and one year after sepsis hospitalization by Veteran age, illness severity, and recent nursing facility use.
Results:
Median days in a healthcare facility increased from 5 to 10. Veterans with recent nursing facility use spent a median 65days (or 86% of days alive) in a healthcare facility in the year after sepsis. Older age, greater illness severity, and recent nursing home use were each associated with spending more days, and a greater proportion of days alive, in a healthcare facility during the year after sepsis. However, none of these characteristics was associated with a greater rise in utilization after sepsis.
Conclusions:
Veterans surviving sepsis experience high rates of post-sepsis mortality and significant increases in healthcare facility use. Recent nursing facility use is strongly predictive of greater post-sepsis healthcare utilization.
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