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The Economic and Humanistic Burden of Severe Sepsis

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Abstract

Sepsis and severe sepsis in particular remain a major health problem worldwide. Their cost to society extends well beyond lives lost, as the impact of survivorship is increasingly felt. A review of the medical literature was completed in MEDLINE using the search phrases “severe sepsis” and “septic shock” and the MeSH terms “epidemiology”, “statistics”, “mortality”, “economics”, and “quality of life”. Results were limited to human trials that were published in English from 2002 to 2014. Articles were classified by dominant themes to address epidemiology and outcomes, including quality of life of both patient and family caregivers, as well as societal costs. The severity of sepsis is determined by the number of organ failures and the presence of shock. In most developed countries, severe sepsis and septic shock account for disproportionate mortality and resource utilization. Although mortality rates have decreased, overall mortality continues to increase and is projected to accelerate as people live longer with more chronic illness. Among those who do survive, impaired quality of life, increased dependence, and rehospitalization increase healthcare consumption and, along with increased mortality, all contribute to the humanistic burden of severe sepsis. A large part of the economic burden of severe sepsis occurs after discharge. Initial inpatient costs represent only 30 % of the total cost and are related to severity and length of stay, whereas lost productivity and other indirect medical costs following hospitalization account for the majority of the economic burden of sepsis. Timeliness of treatment as well as avoidance of intensive care unit (ICU)-acquired illness/morbidity lead to important differences in both cost and outcome of treatment for severe sepsis and represent areas where improvement in care is possible. The degree of sophistication of a health system from a national perspective results in significant differences in resource use and outcomes for patients with serious infections. Comprehensive understanding of the cost and humanistic burden of severe sepsis provides an initial practical framework for health policy development and resource use.

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Acknowledgments

The authors would like to thank Suzanne Gallup for assistance in obtaining the rights for publishing of the figures included in the manuscript.

Author contributions

BT, EKD, WTM designed the study. All authors contributed to literature search, acquisition of data, and the analysis and interpretation of data. All authors participated in drafting the article and approved the final version before publishing. BT and WTM are the guarantors of the entire article.

Conflict of interest

Authors have no conflict of interests. No funding was received for the conduct of this study or preparation of this manuscript.

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Correspondence to Bogdan Tiru.

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Tiru, B., DiNino, E.K., Orenstein, A. et al. The Economic and Humanistic Burden of Severe Sepsis. PharmacoEconomics 33, 925–937 (2015). https://doi.org/10.1007/s40273-015-0282-y

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