As the adult population ages, life-threatening complications from bacterial infections have increased among hospital patients at a double-digit rate, driving billions of dollars in costs to Medicare, according to a Bloomberg report.
For instance, severe sepsis with a major complication was the second-most frequent diagnosis hospitals billed to Medicare in 2013, with more than 398,000 cases, according to a recent report from CMS. That is up 15 percent from 2012 and 24 percent from 2011. In comparison, total payments for the most commonly billed hospital procedure, total joint replacements, only increased by 3.3 percent.
The three sepsis-related codes included in CMS' report — which included data on hospitals' Medicare charges and payments, as well as what Medicare paid physicians and suppliers in 2013 — accounted for roughly $7.2 billion of Medicare's $62 billion in payments to hospitals, 9.5 percent more than in 2012, according to the report.
CMS released data represents more than 7 million diagnoses. The costliest diagnosis in the Medicare data was severe sepsis requiring mechanical ventilation, which accounts for the 100 conditions most often billed by hospitals. The average charge for this condition nationwide was approximately $170,000, while hospitals charged an average of $52,000 for severe sepsis with major complications but without mechanical ventilation, according to the report. Additionally, Medicare usually doesn't reimburse hospitals for these costs in full.
There was a surge of sepsis cases in the last two decades, with diagnoses nearly doubling from 837,000 in 2000 to 1.7 million in 2009, according to HHS. The sharp incline was largely due to a growing aging population and those with cancer, as well as an improved awareness and ability to diagnose and code the disease, according to Eric Adkins, head of the emergency department at Ohio State University's Medical School in Columbus.
"It's a huge burden from a public health perspective," Mr. Adkins told Bloomberg. "The population of people that are susceptible is growing," he said. "You'll see more cases as 50-year-olds become 60-year-olds and 60-year-olds become 70-year-olds."