By Amy Neff Roth
Published by Times Telegram, April 10, 2017.
New York has reduced the number of residents dying of sepsis since new regulations kicked in in 2014, state data shows.
Rory’s Regulations, named after Rory Staunton, 12, of Queens, who died of sepsis after a 2012 fall in the school gym, require hospitals to develop and implement protocols to diagnose and treat sepsis early, the first such requirement in the nation.
The protocols are needed, said Dr. Maria Gesualdo, president of Slocum-Dickson Medical Group and a pulmonary critical care specialist who’s heading up the sepsis initiative at the Mohawk Valley Health System.
“When somebody comes through the (emergency department), there’s a stroke alert,” she said. “We have protocols for myocardial infarction (heart attacks) … but we never had anything for sepsis.”
Sepsis, a dangerous reaction to infection, can progress rapidly, leading to the shutdown of the body’s organs and systems, making early intervention critical. It strikes 750,000 Americans each year, killing 200,000. It is the No. 1 cause of death in the hospital and the 11th leading cause of death overall.
In New York, mortality rates for sepsis among adults fell from 30.2 percent to 25.4 percent from mid-2014 through the end of September in 2016, according to the New York State Department of Health study. And the number of patients diagnosed with sepsis rose 20 percent, meaning hospitals got better at identifying patients, according to the study.
Much of the effort centers around screening all patients with infections to see if they may have or be at risk for sepsis, and the use of two protocol “bundles” for patients with sepsis. A bundle is a group of tests and treatments that all patients matching certain criteria should receive.
The three-hour bundle — care to be delivered within three hours — is to resuscitate patients who are severely septic or in septic shock, Gesualdo said. A six-hour bundle is for patients admitted with sepsis.
It’s not that doctors didn’t already know what to do, but they tended to “piecemeal” their treatments.
“Having it all in one order set, we capture everything,” she said. “We don’t miss any of the important elements.”
At Bassett Medical Center, Rory’s Regulations spurred specific initiatives such as a sepsis work group, an alert system for possible symptoms built into the electronic medical record, a rapid response team for a “coordinated and choreographed response,” and provider and nurse education, including the production of a new training video, said Chief of Medicine Dr. Charles Hyman.
“As a result of the above initiatives, Bassett Medical Center has made considerable progress over the past couple years,” he said. “Our 2016 compliance rate is above that of the (New York state) mean for sepsis protocol.”
That means more patients are receiving the prescribed care — such as a systemic antibiotic within one hour of diagnosis — quickly and fully. And the hospital’s sepsis mortality rate is falling below the state average, Hyman said.
The sepsis initiative has been important to spread awareness of a deadly issue and things are definitely improving, Gesualdo said. But perfect compliance doesn’t happen overnight. “It’s really a big initiative. We still have to iron out some wrinkles,” she said.
“It’s everybody’s responsibility,” she added. “We all have to work as a team. We need that nudging till it becomes knee-jerk response.”
Follow @OD_Roth on Twitter or call her at 315-792-5166.
Ciaran Staunton represented the voice of a sepsis parent advocate speaking on behalf of the Rory Staunton Foundation at the 5th Annual World Patient Safety, Science and Technology Summit in Dana Point, California on February 3rd-4th. Pictured with him here is Jeremy Hunt, MP, Secretary of State for Health in the United Kingdom and Dr. Konrad Reinhart, an international champion of sepsis and chairman of Global Sepsis Alliance.
This important annual Summit brought together international leaders from hospitals, medical and informational technology companies, patient advocacy community, public policy makers and government officials to discuss solutions to the leading challenges that cause preventable patient deaths.
Keynote addresses at the summit included leading figures in the world of politics and health; President Bill Clinton, 42nd President of the United States and Vice President Joe Biden, 47th Vice President of the United States, Joe Kiani Founder, Patient Safety Movement, Rt. Hon. Jeremy Hunt, MP Secretary of State for Health in the United Kingdom, and Patrick Conway, MD, MSC CMS.
We congratulate The Patient Safety Movement for their tireless efforts to improve patient safety and change the world of preventable deaths.
The Rory Staunton Foundation is the leading sepsis advocacy group in the United States and the National Family Council on Sepsis is the only family driven sepsis advocacy group in country comprising families who have lost loved ones to the preventable death of sepsis. The Rory Staunton Foundation and the National Family Council on Sepsis demand mandatory sepsis protocols in all hospitals throughout the United States.
A visit by a friend saved this mans live from sepsis and he tells his story to help others, he too thought he could fight the illness because he did not about sepsis. Rory Staunton Regulations in New York State now enforces all hospitals to have sepsis protocols in place BUT you need to get yourself there if you are feeling unwell. Thank you Joe Caruso for sharing your powerful story and thank you IPRO for the work you are doing getting the message out there.
By Robert Glatter, MD, Contributor
Published by Forbes, January 30, 2017.
Based on a new study evaluating data obtained from the 2013 Nationwide Re-admissions Database, unplanned 30-day readmissions were highest after hospitalizations for sepsis.
Sepsis is a medical condition associated with profound alterations in vital signs, characterized by reduced blood flow to organs, typically triggered by invasive bacterial or viral infections. It is treated aggressively with broad spectrum antibiotics, intravenous fluids, respiratory support, and vasopressors designed to elevate blood pressure when indicated.
But the most unexpected finding from the study was that sepsis represented the leading cause of 30-day readmissions in the U.S. Coupled with this finding, data also indicated that readmissions after treatment for sepsis were also more costly when compared to readmissions after heart attack, heart failure, pneumonia and COPD.
The study should make hospital administrators and CEOs take a step back to examine this important subgroup of patients when evaluating metrics related to 30-day unplanned hospital readmissions since it accounts for a significant costs related to readmissions.
The Centers for Medicare & Medicaid Services (CMS) has typically evaluated readmissions following index or initial hospitalizations for acute myocardial infarction (AMI) or heart attack, heart failure, COPD, and pneumonia, as part of its pay-for-performance program–but not sepsis.
This study, published as a letter in JAMA online late last week, highlights the importance of examining the proportion and cost of unplanned 30-day readmissions following admission for sepsis.
Dr. Sachin Yende, the lead author from VA Pittsburgh Healthcare System in Pennsylvania, evaluated data from the 2013 Nationwide Readmissions Database.
Data from the study indicated that sepsis accounted for over 12% of more than 1.1 million unplanned 30-day readmissions. This was significantly more than readmissions after hospitalizations for heart failure (6.7%), or pneumonia (5.0%), COPD (4.6%), and heart attacks (1.3%).
The study also noted that patients with sepsis also carried diagnoses such as pneumonia (7.5%), heart failure (3.4%), COPD (3.3%), and heart attacks (0.7%).
Compared with readmissions following heart attacks, heart failure, COPD, and pneumonia, the length of stay for unplanned readmissions was greater following hospitalizations for sepsis. Also important to note was that the estimated mean cost per readmission was significantly higher for sepsis ($10,070) compared with pneumonia ($9533) heart attacks ($9424), heart failure ($9051) or COPD ($8417).
So, while recent studies do demonstrate that since the hospital readmission reduction program (HRRP) was launched, readmissions for heart failure, COPD, pneumonia, and heart attack have declined, it would be wise to consider adding sepsis readmissions to HRRP. The potential to avoid hospital acquired infections secondary to readmissions for sepsis would likely help improve health care outcomes.
Its also vital that the public be educated about the dangers of sepsis to facilitate not only early diagnosis and treatment, but rapid dispatch of EMS to the closest emergency department. While sepsis is a medical emergency in patients presenting to the hospital, the more pressing issue is that persons may develop chronic medical issues that can be lifelong or last for years after treatment and discharge.
Patients who survive an initial hospitalization for sepsis require close follow up and must be monitored for development recurrent or worsening kidney failure as well as recurrent infections, recurrent heart failure as well as ongoing lung problems including multidrug resistant pneumonia, CRE, or even aspiration.
One of the pressing issues that emergency and critical care physicians encounter is the difficulty is identifying patients in the early stages of sepsis. Some patients may have nonspecific symptoms such as nausea or dizziness, before changes in mental status or vital signs develop.
In addition, our aging population is at greater risk for sepsis, especially patients who have cancer and are receiving chemotherapy, as well as those with chronic kidney disease and those on hemodialysis.
Data indicates that close to 25% of patients who survive their initial hospitalization for sepsis are then readmitted within 30 days suffering from another potentially deadly infection. But the real challenge is communicating with patients to make them aware of this potential for recurrent infection after initial treatment by instructing them to be aware of early warning signs such as rapid breathing, a low blood pressure, along with confusion or a change in mental status.
In the future, anticipating a recurrent infection may be possible by using wearable sensors to alert clinicians and patients to subtle changes in vital signs (drop in blood pressure, core body temperature, or increase in heart rate) that may be the earliest warning signs of sepsis.
One limitation of this study was that the data was derived from a state-specific registry, so patients could be lost to follow-up, thus underestimating readmission rates.
That said, this study still provides convincing evidence suggesting that sepsis be added to the current list of medical conditions for the existing CMS-derived hospital readmission reduction program (HRRP).
By Mary Brophy Marcus, CBS News
Published by CBS News, January 3, 2017.
When Jose Luis Garrafa started feeling under the weather last month, it seemed like he had caught a bad cold or the flu, but the illness quickly took a more frightening turn.
“Coming out from work, I felt tired, I felt so cold and my body felt so weak,” Garrafa told WLS-TV.
The following day, the Chicago man felt worse.
“He came with his book bag on the floor like a little kid, he was dragging it. And I said, ‘You are getting sick,’” Altagracia Martinez, Garrafa’s fiancee, told the station.
Rest did not bring healing.
Two clinics prescribed medication for cold symptoms, but his health continued to spiral and within days he was admitted to Mount Sinai Hospital in Chicago and diagnosed with sepsis pneumonia, the hospital told CBS News.
Sepsis is a complication of an infection and can progress quickly, leading to tissue damage, organ failure and death. Anyone can be at risk, but older people, babies and those with compromised immune systems are most vulnerable.
Garrafa was in the hospital for 17 days – in the intensive care unit for most of that time, struggling to breathe.
Kevin Dobbins, a critical care nurse who cared for Garrafa, told CBS News he wanted to call attention to “how important it is for members of our community to learn about sepsis,” especially for those without primary care doctors.
A CDC report released last August showed that for almost 80 percent of sepsis patients, the illness begins outside of the hospital. But it also found that 7 in 10 patients with sepsis had recently used health care services or had chronic diseases requiring frequent medical care.
Sepsis can look a lot like a bad cold or the flu. Symptoms include:
Shivering, fever, or very cold
Extreme pain or discomfort
Clammy or sweaty skin
Confusion or disorientation
Shortness of breath
High heart rate
Sepsis is treated with antibiotics, oxygen, IV fluids and other life-saving measures.
Garrafa’s doctor urges people with these symptoms to seek medical care quickly.
“Sepsis is a very serious condition that at first can seem like common ailments. If you ever feel that something is not right, that what you or your loved one has is more than flu or a cold, get medical help right away. Time is life,” pulmonologist Dr. Mira Illiescu-Levine, chairman of the internal medicine department at Mount Sinai Hospital, told CBS News.
The longer a patient goes without treatment, the more likely it is that a sepsis infection will turn fatal.
Every year, severe sepsis strikes more than a million Americans — as many as 50 percent die, according to the National Institutes of Health.
Garrafa’s fiancee said that if one doctor doesn’t listen, seek help elsewhere and “keep asking.”
Garrafa lost 16 pounds and is still recovering. He told WLS-TV he is thankful to be alive. “I’m happy because I’m here. I’m so happy that God gave me one more chance.”
Published: 18:53 EST, 22 November 2016 | Updated: 02:41 EST, 23 November 2016
Hospitals will be docked NHS funding if they do not make strides in tackling sepsis, England’s top doctor has warned.
In a major scheme to reduce the appalling number who die with sepsis each year, hospitals are to lose up to £2million of their NHS funds if they do not hit targets to reduce the problem.
Professor Sir Bruce Keogh, national medical director of NHS England, said 0.25 per cent of each hospital trust’s turnover would be withheld each year unless they made progress.
Hospitals will have to check all patients quickly, give at-risk patients antibiotics within an hour, and introduce new tests to make sure they are not deteriorating.
They will also be expected to come up with innovative new ways to detect the disease – and introduce early warning systems to pick up problems.
‘We want to help frontline staff recognise people with sepsis and be able to treat them quickly,’ Sir Bruce told the Daily Mail. ‘We want organisations to think, in an organisational sense what they can do to help doctors and nurses.
‘We have put some financial incentives into the system, which for a large district general hospital is worth something over £1million a year, and for big places it is something between £1.5million and £2million.’
Sepsis, known as the ‘silent killer’, affects an estimated 200,000 people every year in Britain and kills 44,000 – more than breast, bowel and prostate cancer combined.
A national audit last year found there were delays in diagnosing sepsis in 36 per cent of cases. The illness occurs when a bacterial infection – such as septicaemia or blood poisoning – sparks a violent immune response, in which the body attacks its own organs. If antibiotics are given quickly it can be effectively treated. But sepsis is notoriously difficult to diagnose until it is too late.
Medical advice is that if a child or adult who has had any infection develops one or more of the following symptoms, call 999 and say you are worried about sepsis: feels abnormally cold to touch; looks mottled, bluish or has very pale skin; is breathing very fast; is very lethargic or difficult to wake.
William Mead, top, died from sepris at 12-months-old. His mother Melissa, above, has helped to persuade Health Secretary Jeremy Hunt to launch a public awareness campaign.
A pilot of the scheme last year has already seen huge improvements in A&E departments, with the number undergoing quick checks for sepsis rising from 52 per cent to 78 per cent in the space of a year.
Now it will be extended, with more targets to be introduced in April, including education for GPs and hospital doctors.
The Mail launched the End the Sepsis Scandal campaign in January to raise awareness of symptoms amongst parents and NHS staff.
The campaign was triggered by revelations about the death of William Mead, at the age of 12 months in 2014, after a catalogue of errors, misdiagnoses and missed opportunities by doctors and NHS helpline staff.
Sir Bruce praised the Mail’s campaign – and compared it to the campaign to eradicate the MRSA superbug in 2004, also backed by the newspaper.
He said: ‘The Mail’s perseverance with MRSA was instrumental in policy and practice changes in the NHS, which led to a reduction in MRSA from 7,700 cases in 2003/4 to 819 case in 2015/16 which will undoubtedly have saved many lives.’
The sepsis campaign – spearheaded by William’s mother Melissa, the UK Sepsis Trust and the Mail – has persuaded Health Secretary Jeremy Hunt to launch a public awareness campaign. Details will be announced next month.
When Rory died, the dreadful realization that I would never see his beautiful smiling face and sit and quietly watch him make his way through life very slowly seeped through every bone in my body. The reality that he is dead still drowns our family.
During Rory’s time in hospital we had begged God, besieged everyone who would listen to help us save him. Ciaran and I were told after his death that what he died from was extremely rare – we thought naively at the time… that means no-one could have spotted it, no doctor could have helped us.
But we painfully discovered very soon after his death, that the facts didn’t back up the statement that he had died from something rare. We now know that Rory died from sepsis, that sepsis kills over 258,000 American every year and that most people who become septic arrive at the hospital already very sick. The awful truth for us is that the medical professionals we entrusted with Rory’s care didn’t do what they should have been doing. They should have been looking for sepsis, they didn’t and Rory is dead. If they had diagnosed sepsis and treated him with broad spectrum antibiotics and IV fluids he would be alive.
We have been on a long journey for justice for Rory ever since and along the way we have changed the system in the United States. It has not been an easy journey, in fact at times it was torturous, phone call after phone call, meeting after meeting, but today the good news is that the CDC have launched a major new campaign and channeled millions of dollars to educate healthcare professionals and the general public about sepsis. They have released a Vital Signs report that clearly states that most sepsis cases are acquired in the community and that infection prevention is the single most important this we can do to end unnecessary deaths from sepsis. The education tools, resources and seminars the CDC have put together are nothing short of a major breakthrough in how sepsis is viewed and addressed in this country.
We are proud of our role in bringing this to pass. We are relieved that health care workers and parents will learn more about sepsis from the CDC. Every life is precious. Although we are heartsick that this did not come about soon enough for our boy, we hope and believe that it will save other lives and we are heartened by the fact that it is still possible for a small group of people to affect change on a national scale.
Press Statement from the Rory Staunton Foundation and the Galbo Family
Sepsis Protocols Become Law in Illinois; Galbo Family and Rory Staunton Foundation Call on Other States to Follow;
Illinois becomes second state in the nation after New York to adopt mandatory sepsis protocols; Sepsis kills more than 258,000 Americans each year.
August 18, 2016
URBANA, ILLINOIS: Tony and Elizabeth Galbo and the Rory Staunton Foundation today announced the signing of Gabby’s Law by Illinois Governor Bruce Rauner. Sepsis is a medical condition which is the number one killer in hospitals and the eleventh leading cause of death in the United States. Over 258,000 victims die from sepsis every year – many of them unnecessarily. Since Gabby Galbo’s and Rory Staunton’s unnecessary and certainly untimely deaths, over 1 million Americans have lost their lives to sepsis. And the costs in treating unbridled sepsis reaches over $23 billion per year.
Experts agree that the key to fighting sepsis is ensuring quick diagnosis and treatment within the “golden hour” when it can be most effective. Pilot initiatives in some hospital systems have shown great strides in decreasing sepsis mortality through effective implementation of what is basically a “checklist”: a standardized protocol to facilitate quick and accurate diagnosis and fast and effective treatment as soon as any sign of sepsis arises. But no state, with the exception of New York, has required these simple protocols be implemented at all hospitals. Illinois represents a groundbreaking second.
Tony and Elizabeth Galbo, parents of five year old Gabriella Galbo who needlessly lost her life due to sepsis/septic shock in May of 2012, proudly met with Governor Rauner today in order to officially sign Gabby’s Law into effect. Bill 2403 known as Gabby’s Law will require Illinois hospitals to adopt, implement, and periodically update protocols for the early recognition and treatment of both adult and pediatric patients with sepsis or septic shock.
Gabby’s Law, based on Rory’s Regulations signed into law by Governor Andrew Cuomo in 2013, was drafted to address situations that occur every single day in leading medical institutions across the U.S., which led to the May 2012 unrecognized, untreated, and repeatedly ignored symptoms of sepsis which ultimately led to the death of Gabby Galbo from care which started at a local, well known level 1 trauma hospital.
“This new sepsis bill is vital to protect the citizens of Illinois, both adult and child from unrecognized and untreated sepsis,” the Galbo’s continued. “We hope Illinois, after following in the footsteps of Rory’s Regulations in New York, will trigger other states to immediately follow. If these protocols had been in place at the first hospital in which Gabby received care, we have no doubt that she would have lived. After Gabby’s death we knew something had to be done. Sepsis is very easily screened for, and is very treatable. Just weeks before Gabby’s death 12 year old Rory Staunton of NY died due to unrecognized and untreated sepsis in a major NYC medical institution.”
“I knew if the Staunton family successfully petition New York State to implement these sepsis protocols, then Illinois could and should implement them as well, as should every state,” said Tony Galbo. “I took a printout of Rory’s Regulations as they are named in New York, with me to Representative Bill Mitchell’s office and then to Senator Chapin Rose in order to express the urgent need for a sepsis protocol like this in Illinois so that no family should ever suffer the same consequences. This bill has, will, and is going to continue to save lives in the state of Illinois.”
“Since Gabby’s death four years ago in 2012, over one million Americans (258,000 people a year) have died of sepsis in the United States. Every state could and should adopt a sepsis protocol.
One of the biggest reasons every state does not have a sepsis protocol is because no one has asked! Ask! Take action, contact your governor, contact your state health secretary. Fill out a form which can be found on the www.RoryStauntonFoundation.org website under the Take Action tab, in which you can also find contact numbers for every state. Every day that goes by that legislation is not in place in your state, more needless deaths are occurring from sepsis. You don’t need to start from scratch to implement a sepsis protocol for your state. NY provided a model for IL, and IL and or NY can be the model for the next state,” said Elizabeth Galbo.
Orlaith and Ciaran Staunton, the parents of Rory Staunton and founders of The Rory Staunton Foundation, added, “The Third National Forum on Sepsis will take place in New York City on September 12, 2016. We called the nation to action in implementing sepsis protocols in every state and are very proud that the national initiative that started with New York State is now gaining significant momentum. The Galbo family and Governor Bruce Rauner are fulfilling our mission. Let’s not stop in Illinois! Rory Staunton and Gabby Galbo died unnecessarily. Rory and Gabby deserved to come home from the hospital as does every sepsis patient seeking treatment in any medical institution.”
Read our original piece about Illinois Senate Passing Manatory Statewide Sepsis Regulations below:
Illinois Senate Passes Bill Mandating Statewide Sepsis Regulations
Exciting news out of Illinois last week! The State Senate has passed Bill 2403 mandating that all Illinois hospitals must adopt and implement sepsis protocols. The House will now vote to confirm the protocols.
The bill is based on Rory’s Regulations in New York and is the result of the tireless work of the Galbo family. Five year-old Gabrielle Galbo died from Sepsis on May 11, 2012. The protocols in Illinois will be known as Gabby’s Law, in her honor.
We congratulate the Galbos on their incredible work and welcome them to the National Family Council on Sepsis.
In an emotional conversation with them last night the Galbos committed to working with the Foundation in our efforts to have sepsis protocols in every state in America. Little Gabby should not have died and her parents have been unrelenting in their fight for justice in her name.
Welcome Indiana… the Rory Staunton Foundation is honored to announce that Indiana will conduct a massive month-long Sepsis Awareness campaign partly inspired by Ciaran Staunton during his extensive speaking and media engagements in Indiana in June of this year.
“It (the campaign) would never have taken shape like this without your encouragement and your inspiration and your passion.”-says Jennifer Hurtubise of the Indiana Hospital Association.
Go Indiana…let’s save lives!
Join IHA in Sepsis Awareness Month
Download IHA’s sepsis member toolkit to get involved!
September is Sepsis Awareness Month and in Indiana we have almost 3,500 Hoosiers die from sepsis each year, according to the 2015 Indiana Hospital Association Inpatient Discharge Study.
With September right around the corner, the IHA is hosting a month-long sepsis awareness campaign with the theme, See It. Stop It. Survive It. Throughout the campaign, IHA will be pushing sepsis awareness on social media, hosting four webinars, creating digital media and billboard advertisements, launching survivesepsis.com on Sept. 1 and much more. However, in order to make a larger impact, we need the help of our member hospitals to continue to fight sepsis and generate greater awareness statewide.
We have created a Sepsis Awareness Toolkit and posted the information and artwork on Dropbox, and the files can be downloaded:
FAQ, fact sheet and patient materials – download
Social media guidelines and images – download
Printable poster files – download
Outdoor advertising/billboard designs and art files – download
This member campaign was created to aid in raising sepsis awareness in your hospitals and communities during the month of September but also throughout the year. Additionally, we hope that your hospital can utilize our billboard and poster signage by dedicating a portion of your paid media to the campaign in September. Donating media buys as part of the campaign will help to elevate our awareness efforts, ensuring the campaign is seen and heard statewide. IHA will work with you to provide graphics for your donated advertising opportunity according to the required specs.
On World Sepsis Day, Tuesday, Sept. 13, IHA and its partners will hold a Rally Against Sepsis in downtown Indianapolis to encourage Hoosiers to join in this fight. We will be in touch with additional details about the rally later this month.
If you have any questions regarding Sepsis Awareness Month, our See It. Stop It. Survive It. campaign or how to become more involved, please contact Annette Handy at ahandy@IHAconnect.org or Cynthia Roush at croush@IHAconnect.org.
While progress has been made, we must continue to work to reduce the number of sepsis-related deaths across the state. We ask you to join us to spread the word to save Hoosier lives. Together we will See It. Stop It. Survive It.
Also known as “sepsis,” septicemia is a life-threatening condition, occurring when the body’s response to infection injures its own tissues and organs. It accounted for $23.7 billion, or 6.2 percent of the aggregate costs for all hospitalizations.
Rounding out the top five most expensive conditions are osteoarthritis ($16.5 billion, or 4.3 percent of aggregate costs), newborn infant care ($13.3 billion, or 3.5 percent), acute myocardial infarctions ($21.1 billion, or 3.2 percent), and complications from devices, implants or grafts ($12.4 billion, or 3.3 percent).
Together, those five conditions accounted for about one-fifth of the total aggregate costs for hospitalizations. In 2013, aggregate hospital costs for 35.6 million hospital stays totaled more than $381 billion. The top 20 conditions represented nearly half of aggregate hospital costs.
The primary insurer shares of aggregate hospital costs were 63 percent for Medicare and Medicaid, 28 percent for private insurance and 5 percent for uninsured hospitalizations. Septicemia ranked among the four most costly conditions in the hospital for all four of those payer groups.
Given payer differences in demographic mix and service coverage, certain conditions were more common for some payer groups than for others. Osteoarthritis and back problems were top-ranked among hospital stays covered by Medicare and private insurance.
Hospitalizations associated with pregnancy and childbirth accounted for five of the 20 most expensive conditions covered by Medicaid, while mood disorders were a top-ranked condition for stays covered by Medicaid and private insurance, and for uninsured stays.
The study authors said that although just 7.2 percent of the population had a hospital inpatient stay in 2012, the mean expense per stay was over $18,000, enough to make hospitalization one of the most expensive types of healthcare treatment.