The burden and costs of sepsis and reimbursement of its treatment in a developing country: An observational study on focal infections in Indonesia. (July 2020)

• Record Type: Journal Article
• Authors: Purba, Abdul Khairul Rizki; Mariana, Nina; Aliska, Gestina; Wijaya, Sonny Hadi; Wulandari, Riyanti Retno; Hadi, Usman; Hamzah, ; Nugroho, Cahyo Wibisono; van der Schans, Jurjen; Postma, Maarten J.
• Is Part Of: International journal of infectious diseases. Volume 96(2020)
• Page Start: 211
• Page End: 218
• Publication Date: 2020-07
• Subjects: Sepsis -- Focal infection -- Survivors -- Developing countries -- Universal health insurance -- Hospital costs; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.04.075
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Deceased costs for sepsis patients exceeded those incurred for surviving patients. Sepsis-related costs specifically reflected the underlying focal infection. Sepsis with multifocal infection reflected the highest national burden. Sepsis with cardiovascular infection came with the highest reimbursement. Sepsis reimbursement in Indonesia was not being aligned with the actual costs. Abstract: Objectives: This study aimed to determine the burden of sepsis with focal infections in the resource-limited context of Indonesia and to propose national prices for sepsis reimbursement. Methods: A retrospective observational study was conducted from 2013–2016 on cost of surviving and non-surviving sepsis patients from a payer perspective using inpatient billing records in four hospitals. The national burden of sepsis was calculated and proposed national prices for reimbursement were developed. Results: Of the 14, 076 sepsis patients, 5, 876 (41.7%) survived and 8, 200 (58.3%) died. The mean hospital costs incurred per surviving and deceased sepsis patient were US$1, 011 (SE ± 23.4) and US$1, 406 (SE ± 27.8), respectively. The national burden of sepsis in 100, 000 patients was estimated to be US$130 million. Sepsis patients with multifocal infections and a single focal lower-respiratory tract infection (LRTI) were estimated as being the two with the highest economic burden (US$48 million and US$33 million, respectively, within 100, 000 sepsis patients). Sepsis with cardiovascular infection was estimated to warrant the highest proposed national price for reimbursement (US$4, 256). Conclusions: Multifocal infections and LRTIs are the major focal infections with the highest burden of sepsis. This study showed varying cost estimates for sepsis, necessitating a new reimbursement system with adjustment of the national prices taking the particular foci into account.