A state-wide implementation of a whole of hospital sepsis pathway with a mortality based cost-effectiveness analysis from a healthcare sector perspective
Bibliographic Data
| ID | 19590944 |
|---|---|
| Authors | Natasha Brusco (0000-0002-8825-5109, La Trobe University, corresponding author), Kelly Sykes (Government of Victoria, corresponding author), Allen C Cheng (0000-0003-3152-116X, Monash Health, corresponding author), Camilla Radia-George (corresponding author), Douglas Travis (0000-0003-3389-0970, Western Health, corresponding author), Natalie Sullivan (0000-0001-5251-4562, La Trobe University, corresponding author), Tammy Dinh (Government of Victoria, corresponding author), Sarah Foster (0000-0002-8624-4908, Peninsula Health, corresponding author), Karin Thursky (0000-0002-7400-232X, The Royal Melbourne Hospital, corresponding author) |
| Editors | Madhukar Pai (0000-0003-3667-4536) |
| Year | 2023 |
| Volume | 3 |
| Issue | 5 |
| Pages | e0000687 |
| Publication date | 2023-05-19 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | PLOS Global Public Health (JOURNAL) |
| Journal identifiers | ISSN: 2767-3375 • E-ISSN: 2767-3375 |
| Publisher | Public Library of Science (PLoS) (PUBLISHER) |
| DOI | 10.1371/journal.pgph.0000687 |
| PMID | 37205639 |
| OpenAlex | W4377115770 |
| Language | EN |
| Citations received | 1 |
| References cited | 22 |
With global estimates of 15 million cases of sepsis annually, together with a 24% in-hospital mortality rate, this condition comes at a high cost to both the patient and to the health services delivering care. This translational research determined the cost-effectiveness of state-wide implementation of a whole of hospital Sepsis Pathway in reducing mortality and/or hospital admission costs from a healthcare sector perspective, and report the cost of implementation over 12-months. A non-randomised stepped wedge cluster implementation study design was used to implement an existing Sepsis Pathway (“Think sepsis. Act fast”) across 10 of Victoria’s public health services, comprising 23 hospitals, which provide hospital care to 63% of the State’s population, or 15% of the Australian population. The pathway utilised a nurse led model with early warning and severity criteria, and actions to be initiated within 60 minutes of sepsis recognition. Pathway elements included oxygen administration; blood cultures (x2); venous blood lactate; fluid resuscitation; intravenous antibiotics, and increased monitoring. At baseline there were 876 participants (392 female (44.7%), mean 68.4 years); and during the intervention, there were 1,476 participants (684 female (46.3%), mean 66.8 years). Mortality significantly reduced from 11.4% (100/876) at baseline to 5.8% (85/1,476) during implementation (p>0.001). Respectively, at baseline and intervention the average length of stay was 9.1 (SD 10.3) and 6.2 (SD 7.9) days, and cost was $AUD22,107 (SD $26,937) and $14,203 (SD $17,611) per patient, with a significant 2.9 day reduction in length of stay (-2.9; 95%CI -3.7 to -2.2, p
Environmental health · Health care · Intensive care medicine · Population · Public health · Sepsis · Clinical practice guidelines implementation · Health Systems, Economic Evaluations, Quality of Life · Medicine · Nursing · Sepsis Diagnosis and Treatment · Emergency Medicine · Internal Medicine
Consolidated Health Economic Evaluation Reporting Standards (CHEERS)—Explanation and Elaboration
The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
Research electronic data capture (Redcap)—A metadata-driven methodology and workflow process for providing translational research informatics support
The Redcap consortium
| Unique citing works | 1 |
|---|---|
| Citations per year | 1 |
| Citation span | 2026 - 2026 (1) |
| Citation velocity | current |
| Highly cited | No |