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Implementation of an Automated Sepsis Screening Tool in a Children's Hospital Emergency Department: A Cost Analysis
Jason R Toews1, Julie C Leonard2, Junxin Shi2
1Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, OH; Division of Emergency Medicine, Dayton Children's Hospital, Dayton, OH.
Insights
Implementing an automated sepsis screening tool significantly reduced patient care costs in a pediatric emergency department. Sepsis patient costs saw an even greater reduction, suggesting the tool is cost-effective.
Area of Science:
- Pediatric Emergency Medicine
- Health Informatics
- Healthcare Economics
Background:
- Sepsis is a life-threatening condition requiring timely diagnosis and treatment.
- Automated screening tools aim to improve sepsis detection and management.
- Cost-effectiveness of such tools is crucial for widespread adoption.
Purpose of the Study:
- To evaluate the impact of an automated sepsis screening tool on patient encounter costs.
- To assess cost changes in a pediatric emergency department before and after tool implementation.
Main Methods:
- Retrospective cohort study utilizing propensity score-matched comparison groups.
- Comparison of median costs for patient encounters in 2018 (post-implementation) versus 2012 (pre-implementation).
- Analysis of costs for all affected patient encounters and specifically for those with sepsis codes.
Main Results:
- Overall median costs decreased by 21.2% after tool implementation.
- Median costs for patients with sepsis codes decreased by 51.1%.
- The automated tool demonstrated a significant reduction in healthcare costs.
Conclusions:
- Automated sepsis screening tools can decrease median patient encounter costs in pediatric emergency departments.
- The tool shows substantial cost savings for patients with sepsis.
- The technology appears cost-effective and potentially cost-saving, encouraging wider implementation.
Objective:
To determine the effect of implementation of an automated sepsis screening tool on the median cost of affected patient encounters.
Study Design:
This retrospective cohort study used propensity score-matched comparison groups to assess the difference in median cost for comparable affected patient encounters before and after the implementation of an automated sepsis screening tool in a large US children's hospital emergency department (ED) with >90 000 annual visits. All patient encounters in 2018 impacted by the automated sepsis screening tool were included and compared with a propensity score-matched comparison group drawn from patient encounters in 2012 that might have been affected by the screening tool had it been active at that time. The main outcome was the change in the median cost for comparable affected patient encounters.
Results:
The overall median cost for those affected by an automated sepsis screening tool decreased by 21.2%, from $6454 (IQR, $968-$21 697) to $5084 (IQR, $802-$16 618). The median cost for encounters with an associated International Classification of Diseases sepsis code decreased by 51.1%, from $58 685 (IQR, $32 224-$134 895) to $28 672 (IQR, $16 796-$60 657).
Conclusions:
The median cost for comparable patient encounters decreased with implementation of an automated sepsis screening tool in the pediatric ED. Costs were decreased even more substantially for patients with sepsis. In addition to improving outcomes, an automated sepsis screening tool appears to be at least cost-effective and may be cost-saving, an incentive for more widespread use of this technology.
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