Evidence map›Paper›PMID 32931187›Full record

ArticleCritical care medicine2020

Economic Analysis of Mandated Protocolized Sepsis Care in New York Hospitals.

Donald S Bourne, Billie S Davis, Kristin H Gigli, Chung-Chou H Chang, Jonathan G Yabes, Grant R Martsolf, Jeremy M Kahn

Open access · greenAbstract read
In one paragraph

Article in Critical care medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Donald S BourneCRISMA Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Billie S DavisCRISMA Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Kristin H GigliCRISMA Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Chung-Chou H ChangDivision of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Jonathan G YabesDivision of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Grant R MartsolfDepartment of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA.
Jeremy M KahnCRISMA Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
University of Pittsburgh · USRAND Corporation · US

Funding

TRAINING PROGRAM FOR MD/PHD STUDENTST32GM008208 · NIGMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI STEINMAN, RICHARD A · 1987 to 2021
$15.4M
Multidisciplinary Training in Critical Care Outcomes ResearchT32HL007820 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Timothy D Girard, Jeremy M Kahn · 1996 to 2026
$6.4M
The effects of state sepsis mandates on hospital mortality, health care utilization, and costsR01HS025146 · AHRQ · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KAHN, JEREMY M · 2017 to 2020
$1.5M
AHRQ HHS R01 HS025146NHLBI NIH HHS T32 HL007820NIGMS NIH HHS T32 GM008208
6 · The paper itself

Abstract

objectivesInitial evidence suggests that state-level regulatory mandates for sepsis quality improvement are associated with decreased sepsis mortality. However, sepsis mandates require financial investments on the part of hospitals and may lead to increased spending. We evaluated the effects of the 2013 New York State sepsis regulations on the costs of care for patients hospitalized with sepsis.

designRetrospective cohort study using state discharge data from the U.S. Healthcare Costs and Utilization Project and a comparative interrupted time series analytic approach. Costs were calculated from admission-level charge data using hospital-specific cost-to-charge ratios.

settingGeneral, short stay, acute care hospitals in New York, and four control states: Florida, Massachusetts, Maryland, and New Jersey. PATIENTS: All patients hospitalized with sepsis between January 1, 2011, and September 30, 2015.

interventionsThe 2013 New York mandate that all hospitals develop and implement protocols for sepsis identification and treatment, educate staff, and report performance data to the state. MEASUREMENTS AND MAIN

resultsThe analysis included 1,026,664 admissions in 520 hospitals. Mean unadjusted costs per hospitalization in New York State were $42,036 ± $60,940 in the pre-regulation period and $39,719 ± $59,063 in the post-regulation period, compared with $34,642 ± $52,403 pre-regulation and $31,414 ± $48,155 post-regulation in control states. In the comparative interrupted time series analysis, the regulations were not associated with a significant difference in risk-adjusted mean cost per hospitalization (p = 0.12) or risk-adjusted mean cost per hospital day (p = 0.44). For example, in the 10th quarter after implementation of the regulations, risk-adjusted mean cost per hospitalization was $3,627 (95% CI, -$681 to $7,934) more than expected in New York State relative to control states.

conclusionsMandated protocolized sepsis care was not associated with significant changes in hospital costs in patients hospitalized with sepsis in New York State.

Indexed as

AgedAged, 80 and overAge FactorsClinical ProtocolsFemaleHospital Bed CapacityHospital CostsHumansInservice TrainingInterrupted Time Series AnalysisLength of StayMaleMiddle AgedNew YorkOwnershipPatient Discharge

Identifiers

PMID32931187
PMCPMC7875140
OpenAlexW3047090124

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.