Hospitalizations for Severe Sepsis in California

Sepsis is a preventable, life-threatening medical condition, which if not treated timely and properly, can result in a severe condition with multiple organ failure (severe sepsis) and death. Sepsis impacts approximately 1.7 million people annually in the United States. Hospitalizations for sepsis are among the most expensive (CDC: What is Sepsis?); for example, in California, hospital charges totaled $75 billion in 2020 (HCAI Patient Discharge Data).  

The visualizations below present patient information on in-hospital and 30-day mortality, length of stay, charges, and payers for severe sepsis hospitalizations, along with hospital characteristics including hospital size, location, ownership, and designations as a teaching facility.

In 2020, COVID-19 may have had an impact on the number of severe sepsis cases; 16.4 percent of severe sepsis patients also had a diagnosis of COVID-19, and 29.8 percent of severe sepsis patients who died in the hospital had diagnosis of COVID-19 (HCAI Patient Discharge Data). In addition, HCAI analyses of  2020 data show the Effects of COVID-19 on Hospital Utilization Trends and mortality. 

Severe Sepsis – Patient Information

Key Findings:

  • From 2013-2019, the number of severe sepsis cases nearly doubled, while the number of in-hospital deaths for severe sepsis remained the same. However, in 2020, the number of in-hospital severe sepsis deaths increased 39.5 percent from 2019.
  • While the number of hospital-acquired severe sepsis cases remained steady over the last several years, 2020 saw these type of cases rise 18 percent, and non-hospital cases increased 9.6 percent. Over the last several years, non-hospital severe sepsis cases have outnumbered in-hospital cases.
  • Even though the average length of stay for severe sepsis decreased, the median charge per day increased by 22 percent. Charges may not reflect the actual cost paid by the patient.
  • Medicare was the expected payer for more hospitalized severe sepsis cases than any other payer, followed by Medi-Cal, and Private Coverage. 
  • With the introduction of Hospice Care as a discharge category in 2015, most severe sepsis patients who died within 30 days following discharge died at a hospice care facility, while the percentage of deaths in skilled nursing facilities gradually declined over the years. 
  • The percentage of hospital-acquired severe sepsis patients who died within 30 days of discharge decreased over time, with a slight increase in 2020.

Patient Information, 2013-2020

Severe Sepsis – Hospital Characteristics

Key Findings:

  • The smallest hospitals (1-99 beds) had the highest rates of hospital-acquired severe sepsis compared to other facility sizes.
  • Urban hospitals had approximately double the rates of hospital-acquired severe sepsis compared to rural hospitals. The rates for both urban and rural facilities remained consistent over time until 2020, when hospitalization rates increased 200 percent for rural hospitals and increased 30 percent for urban hospitals.
  • Nonprofit hospitals had the lowest rates of hospital-acquired severe sepsis.
  • Teaching hospitals had higher rates of hospital-acquired severe sepsis compared to non-teaching hospitals. The rates in teaching hospitals increased steadily, with the largest increase between 2019 and 2020.

Hospital Characteristics, 2013-2020

General Information About Sepsis

  • Sepsis: the body’s extreme response to an infection. Almost any type of infection can lead to sepsis.
  • Sepsis symptoms: high heart rate or low blood pressure, chills, fever, extreme pain or discomfort, confusion, shortness of breath or clammy/sweaty skin.
  • Hospital-acquired sepsis: acquired while a patient is hospitalized for another illness or procedure.
  • Severe sepsis: without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.
  • People in high-risk of developing sepsis: the very young, the very old, those with chronic illnesses, and those with a weakened or impaired immune system.
  • For more information on sepsis visit the Centers for Disease Control and Prevention website.

Additional Information

Topic: Healthcare Quality
Temporal Coverage: 2013-2020
Spatial/Geographic Coverage: Statewide
Geographic Granularity: Statewide
Frequency: Annually
Source Link: https://data.chhs.ca.gov/dataset/california-inpatient-severe-sepsis
Citation: Department of Health Care Access and Information: Patient Discharge Data