IDEAS home Printed from https://ideas.repec.org/a/plo/pgph00/0000687.html
   My bibliography  Save this article

A state-wide implementation of a whole of hospital sepsis pathway with a mortality based cost-effectiveness analysis from a healthcare sector perspective

Author

Listed:
  • Natasha K Brusco
  • Kelly Sykes
  • Allen C Cheng
  • Camilla Radia-George
  • Douglas Travis
  • Natalie Sullivan
  • Tammy Dinh
  • Sarah Foster
  • Karin Thursky
  • on behalf of the Safer Care Victoria “Think sepsis. Act fast” Scaling Collaboration

Abstract

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

Suggested Citation

  • Natasha K Brusco & Kelly Sykes & Allen C Cheng & Camilla Radia-George & Douglas Travis & Natalie Sullivan & Tammy Dinh & Sarah Foster & Karin Thursky & on behalf of the Safer Care Victoria “Think seps, 2023. "A state-wide implementation of a whole of hospital sepsis pathway with a mortality based cost-effectiveness analysis from a healthcare sector perspective," PLOS Global Public Health, Public Library of Science, vol. 3(5), pages 1-21, May.
    • Handle: RePEc:plo:pgph00:0000687
    DOI: 10.1371/journal.pgph.0000687
    as

    Download full text from publisher

    File URL: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000687
    Download Restriction: no
    File URL: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0000687&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pgph.0000687?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jaithri Ananthapavan & Marj Moodie & Andrew J. Milat & Rob Carter, 2021. "Systematic Review to Update ‘Value of a Statistical Life’ Estimates for Australia," IJERPH, MDPI, vol. 18(11), pages 1-17, June.
    2. repec:plo:pone00:0125827 is not listed on IDEAS
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Liang Tan & Aochen Cao & Dongyang Qiu & Bolin Liang, 2023. "Life Value Assessment Methods in Emerging Markets: Evidence from China," Sustainability, MDPI, vol. 15(10), pages 1-13, May.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pgph00:0000687. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: globalpubhealth (email available below). General contact details of provider: https://journals.plos.org/globalpublichealth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.