Sepsis is frequently associated with hospital readmission. Readmission is a hospital quality measure that reflects dimensions of quality of inpatient care and also impacts overall programs by payors such as CMS’s Star Rating Program, HRRP and Value-Based Purchasing. Cefdinir is a cephalosporin antibiotic that treats many types of bacterial infections. Studies have shown that appropriate and timely antibiotic treatment is one of the cornerstones of therapy to prevent deaths and life-threatening complications
Dexur’s analysis of Real World Evidence based on Medicare Claims data showed that the use of Cefdinir within 7 days of hospitalization was associated with lower hospital readmission rates for Sepsis Patients at Florida Hospital Orlando in Orlando, Florida. Reduction in readmission rates helps hospitals improve their outcomes for various cost and quality programs. Dexur is an approved entity to perform Medicare claims data analysis, which it uses to perform quality outcomes analysis. Dexur has published several papers with Harvard Medical School on quality outcomes related topics. Dexur’s analysis of Drugs and their impact on quality outcomes, such as readmissions and mortality, are used by Hospitals, IDNs, and ACOs to implement best practices and manage Real World Evidence based risk factors.
We conducted a retrospective study using Dexur’s analysis of Real World Evidence from Medicare Claims data, for hospitalizations at Florida Hospital Orlando between January 2017 to September 2019. Our methodology criteria was as follows:
Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Sepsis related codes (Listed in table below)
Stratified Selected population into cohorts
Sepsis patients who dispensed Cefdinir within 7 Days of Hospitalization using Part D drugs claims database
Sepsis patients who did not dispense Cefdinir within 7 Days of Hospitalization
30 Day readmission rates were analyzed for both population cohorts
Overall, Cefdinir was associated with lower hospital readmission rates for all Primary ICD/DRG Diagnosis Codes examined at Florida Hospital Orlando. For patients whose primary ICD Diagnosis was “Sepsis, unspecified organism”(A419) and when Cefdinir was used within 7 days of hospitalization, the readmission rate was 18.38% compared to the cohort where Cefdinir was not used, whose readmission rate was 24.36%. The readmission odds ratio for these cohorts was 0.70. The use of Cefdinir was associated with a 30% lower readmission rate when used within 7 days of hospitalization. The full list of studied ICD/DRG codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Cefdinir at Florida Hospital Orlando is shown below.
|Primary ICD/DRG Diagnosis Code||Primary ICD/DRG Diagnosis Code Description||Total Hospitalizations without Cefdinir||Readmission Without Cefdinir||Readmission Rate without Cefdinir||Total Hospitalizations with Cefdinir||Readmission with Cefdinir||Readmission Rate with Cefdinir||Readmission Odds Ratio||Reduction in Readmission with Cefdinir (%)||Confidence Interval (-)||Confidence Intervals (+)|
|A419||Sepsis, unspecified organism||7,154|
|871||Septicemia Or Severe Sepsis Without Mv >96 Hours With Major Complication Or Comorbidity (MCC)||5,396|
Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Sepsis were not prescribed Cefdinir within 7 days of discharge.
|ICD/DRG CODE||Hospital||Hospitalizations with Sepsis||% of Hospitalizations without Cefdinir|
|A419||Florida Hospital Orlando||7,245||98.74%|
|Methodist University Hospital||4,760||99.75%|
|871||Florida Hospital Orlando||5,455||98.92%|
|Centinela Hospital Medical Center||1,697||At least 98.88%|
|Oroville Hospital||3,317||At least 99.67%|
Hospitalizations with Sepsis = Above Listed ICD/DRG Codes
If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11
According to analysis of Real World Evidence of Medicare Claims data, for hospitalizations between January 2017 to September 2019, the use of Cefdinir within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Sepsis patients at Florida Hospital Orlando. This analysis shows that a significant number of Patients are not dispensed Cefdinir after Sepsis hospitalizations at Florida Hospital Orlando or major US Hospitals.