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The following is a summary of “High-cost users after sepsis: a population-based observational cohort study,” published in the October 2024 issue of Critical Care by Barrett et al. 

High-cost users (HCU) are represented as the key targets for health policy interventions, and sepsis is a life-threatening syndrome associated with high morbidity, mortality, and economic costs to the healthcare system.  

They used health-administrative databases of adults who survived hospitalization in Ontario, Canada, between January 2016 and December 2017. Sepsis was identified through a validated algorithm. The primary outcome measured was being persistent HCU after hospital discharge, defined as being in the top 5% or 1% of total healthcare spending for 90 consecutive days and the proportion of follow-up time since discharge as an HCU.  

The results showed that 9,27,057 hospitalized individuals were identified, with 79,065 with sepsis, more likely to be in the top 5% of HCU for 90 consecutive days after discharge compared to those without sepsis (odds ratio [OR] 2.24; 95% CI 2.04–2.46) and spent an average of 42.3% of their follow-up time as a top 5% HCU, while those without sepsis spent 28.9% (relative risk [RR] 1.46; 95% CI 1.45–1.48). Individuals with sepsis also had a higher likelihood of being in the top 1% HCU for 90 consecutive days (10% vs 5.1%, OR 2.05 [95% CI 1.99–2.11]) and spent more time as a top 1% HCU (18.5% of time vs 10.8% of time, RR 1.68 [95% CI 1.65–1.70]).  

They concluded the sequelae of sepsis led to higher healthcare costs and that individuals with sepsis were more likely to be HCU and spent more time as HCU, compared to those who did not experience sepsis during hospitalization. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05108-6