Healthcare Use and Expenditures in Rural Survivors of Hospitalization for Sepsis

Area of Science:

• Health Services Research
• Epidemiology
• Public Health

Background:

• Sepsis survivors experience increased healthcare utilization compared to other patient groups.
• Rural populations face unique healthcare access barriers and health disparities.
• Understanding post-sepsis healthcare needs in rural vs. urban settings is crucial.

Purpose of the Study:

• To compare healthcare use and expenditures between rural and urban sepsis survivors.
• To investigate factors influencing healthcare utilization patterns post-sepsis.

Main Methods:

• Analysis of over 106,000 adult sepsis survivors from 2013-2018 using IBM MarketScan and Medicare data.
• Categorization of patients as rural or urban based on Metropolitan Statistical Area classifications.
• Multivariable regression analysis to compare emergency department visits, hospitalizations, and expenditures, adjusting for key covariates.

Main Results:

• Rural survivors showed higher odds of emergency department (ED) visits (17%) but lower odds of primary care visits (9%) and home healthcare (12%).
• Despite increased ED use and similar readmission rates, rural survivors had lower overall expenditures in these areas.
• Findings suggest potential differences in the acuity of conditions treated in rural EDs and home healthcare settings.

Conclusions:

• Significant differences exist in healthcare use and spending between rural and urban sepsis survivors.
• Further research and policy interventions are necessary to optimize sepsis survivorship across diverse geographic settings.
• Addressing rural-urban disparities in post-sepsis care is essential for equitable health outcomes.