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

Abdul Khairul Rizki Purba, Nina Mariana, Gestina Aliska, Sonny Hadi Wijaya, Riyanti Retno Wulandari, Usman Hadi, Hamzah, Cahyo Wibisono Nugroho, Jurjen van der Schans, Maarten J. Postma

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)211-218
Number of pages8
JournalInternational Journal of Infectious Diseases
Volume96
DOIs
Publication statusPublished - Jul 2020

Keywords

  • Developing countries
  • Focal infection
  • Hospital costs
  • Sepsis
  • Survivors
  • Universal health insurance

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