Abstract:
This systematic review of 23 studies (2000–2025) examined healthcare costs among adult sepsis survivors in developed nations. While in-hospital sepsis costs are well described, this review reveals that post-discharge healthcare costs remain high for years. Median one-year cost per survivor was $28,719 (IQR $21,715), with second-year costs still averaging $22,460 (IQR $14,407). Median cost of a readmission was $20,320 (IQR $4,889). In studies with comparators, sepsis survivors consistently accrued higher costs than non-sepsis survivors.
Key Insights
- Scope: 23 cohort studies, sample sizes up to 2.5M patients, across US, Canada, Germany, France, Latvia, Australia.
- Persistence of costs: High expenditures persisted beyond 5 years, especially from rehospitalizations and long-term care.
- Drivers: Readmissions, outpatient visits, medications, rehabilitation, and chronic care services.
- Comparisons: Sepsis survivors had significantly higher costs than matched non-sepsis controls in 6 of 7 comparator studies.
- High-cost users: Sepsis survivors disproportionately became top 5% healthcare spenders, consuming major system resources.
- Policy relevance: Supports WHA resolution 70.7 and Berlin Declaration to reduce long-term sepsis burden.
Why This Matters
Sepsis is not only a leading killer but also a driver of chronic healthcare costs. Survivors face prolonged disability, readmissions, and high health service utilization. For policymakers, post-sepsis care planning is as critical as in-hospital management.
Conclusion
Sepsis survivors generate sustained, high post-discharge costs that burden health systems for years. Strategies to reduce readmissions, improve rehabilitation, and prevent long-term complications are urgently needed.
Take-Home for Clinicians
- Monitor sepsis survivors long-term—rehospitalizations are common and costly.
- Advocate for rehabilitation and coordinated outpatient care to reduce economic and clinical burden.
- Recognize survivors as high-cost, high-risk patients in need of proactive follow-up.
Discussion Question: Should sepsis pathways include structured long-term follow-up clinics to reduce readmissions and costs, similar to post-MI or post-stroke programs?
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