Levaquin(Levofloxacin) is associated with Lower Hospital Readmission Rates for Sepsis Patients at Cedars Sinai Medical Center based on Real World Evidence Study of Medicare Claims Data


In Levaquin, Sepsis

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By: Sara Riascos  Apr. 19, 2022

Background:

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. Levaquin(Levofloxacin) is a prescription medicine used to treat the symptoms of various bacterial infections. Studies have shown that treatment with Levaquin(Levofloxacin) was as effective and well tolerated for patients hospitalized with suspected bacteraemia/sepsis.

Dexur’s analysis of Real World Evidence based on Medicare Claims data showed that the use of Levaquin(Levofloxacin) within 7 days of hospitalization was associated with lower hospital readmission rates for Sepsis Patients at Cedars Sinai Medical Center in Los Angeles, California. 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.

Methods:

We conducted a retrospective study using Dexur’s analysis of Real World Evidence from Medicare Claims data, for hospitalizations at Cedars Sinai Medical Center between January 2017 to September 2019. Our methodology criteria was as follows:

  1. Inclusion Criteria: Selected Medical Hospitalizations with Primary Diagnosis with Sepsis related codes (Listed in table below)
  2. Stratified Selected population into cohorts
    1. Sepsis patients who dispensed Levaquin(Levofloxacin) within 7 Days of Hospitalization using Part D drugs claims database
    2. Sepsis patients who did not dispense Levaquin(Levofloxacin) within 7 Days of Hospitalization
  3. 30 Day readmission rates were analyzed for both population cohorts

Results:

Overall, Levaquin(Levofloxacin) was associated with lower hospital readmission rates for all Primary DRG/ICD Diagnosis Codes examined at Cedars Sinai Medical Center. For patients whose primary DRG/ICD Diagnosis was “Septicemia Or Severe Sepsis Without Mv >96 Hours With Major Complication Or Comorbidity (MCC)” (871) and when Levaquin(Levofloxacin) was used within 7 days of hospitalization, the readmission rate was 25.86% compared to the cohort where Levaquin(Levofloxacin) was not used, whose readmission rate was 28.23%. The readmission odds ratio for these cohorts was 0.88. The use of Levaquin(Levofloxacin) was associated with a 12% lower readmission rate when used within 7 days of hospitalization. The full list of studied DRG/ICD codes, readmission rates, odds ratios, confidence intervals, and percentage reduction in readmission with Levaquin(Levofloxacin) at Cedars Sinai Medical Center is shown below.


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Primary DRG/ICD Diagnosis Code Primary DRG/ICD Diagnosis Code Description Total Hospitalizations without Levaquin(Levofloxacin) Readmission Without Levaquin(Levofloxacin) Readmission Rate without Levaquin(Levofloxacin) Total Hospitalizations with Levaquin(Levofloxacin) Readmission with Levaquin(Levofloxacin) Readmission Rate with Levaquin(Levofloxacin) Readmission Odds Ratio Reduction in Readmission with Levaquin(Levofloxacin) (%) Confidence Interval (-) Confidence Intervals (+)
871 Septicemia Or Severe Sepsis Without Mv >96 Hours With Major Complication Or Comorbidity (Mcc) 3,563 1006 28.23% 58 15 25.86% 0.88 12% -3% -1%
A419 Sepsis, unspecified organism

Dexur also leveraged Medicare claims data to understand what percentage of patients hospitalized with Sepsis were not prescribed Levaquin(Levofloxacin) within 7 days of discharge.

DRG/ICD CODE Hospital Hospitalizations with Sepsis % of Hospitalizations without Levaquin(Levofloxacin)
871 Cedars Sinai Medical Center 3,578 99.58%
Memorial Hermann Southwest Hospital 3,812 99.69%
Providence Hospital And Medical Center 2,939 99.22%
A419 Memorial Hermann Southwest Hospital 4,555 99.50%
Cedars Sinai Medical Center 3,361 99.55%
Christus St Michael Hospital 1,969 99.44%

​Hospitalizations with Sepsis = Above Listed DRG/ICD Codes

If figures are shared with “At Least” - this implies that the drug utilization within 7 days post hospitalization is less than 11

Conclusions:

According to analysis of Real World Evidence of Medicare Claims data, for hospitalizations between January 2017 to September 2019, the use of Levaquin(Levofloxacin) within 7 days of hospitalization can lead to substantial reductions in hospital readmission rates of Sepsis patients at Cedars Sinai Medical Center . This analysis shows that a significant number of Patients are not dispensed Levaquin(Levofloxacin) after Sepsis hospitalizations at Cedars Sinai Medical Center or major US Hospitals.