Sepsis, a life-threatening infection that is often acquired during a patient's hospital stay, remains the most costly condition for hospitals to treat.
AHRQ sifted through coding, claims and cost data from 2013 for a host of illnesses and routine medical conditions that require hospitalization. There are some limitations with AHRQ's analysis: The figures represent the hospital's cost to produce the services, not the actual amount paid by the government or insurers. The costs also do not include the physician fees associated with the hospitalization.
Researchers ultimately found there were 35.6 million hospital stays in 2013, costing more than $381 billion across all payers. Patients on Medicare accounted for 46% of those costs, and patients with commercial insurance made up 28% of hospitalization costs.
Sepsis, or septicemia, was by far the most costly condition across all payers. Patients with sepsis represented $23.7 billion in hospital costs, or about 6.2% of the nation's hospital bill, but sepsis patients represented only 3.6% of all hospital stays.
Many patients with sepsis may experience organ failure and need to stay in the intensive-care unit, which is costly to run. Legendary boxer Muhammad Ali died earlier this month after battling septic shock. The illness also has commanded the attention of health system leaders, who have tried to raise awareness and improve medical training.
The most common reason people stay in the hospital is childbirth, representing 10.6% of hospitalizations, but that diagnosis is only the third-most expensive, costing $13.3 billion in 2013, according to AHRQ data. The other costly medical conditions in the top five for 2013 were osteoarthritis, complications stemming from devices or implants, and heart attacks.
The last time sepsis wasn't the most expensive condition was 2008, when a mother's childbirth charges held the top spot and sepsis was No. 2. That's also when AHRQ, which has faced defunding threats from Congress, only analyzed the data as hospital charges, which typically are higher than hospital costs. In 2004, sepsis ranked ninth among the most expensive conditions, and it represented 2.3% of all hospitalization charges.
Some medical conditions are most costly for specific payers. For example, sepsis ranks as the most expensive diagnosis for all payers, Medicare and the uninsured, but childbirth cost the most for Medicaid in 2013. Almost 1 in 5 Medicaid hospital stays are for women giving birth. The most expensive condition billed to private insurers in 2013 was osteoarthritis.