Hospitals that spend more on patient care do not appear to have higher survival rates for patients being treated for the acute bacterial infection sepsis, according to research appearing in the February 28 issue of Archives of Internal Medicine.

Sepsis, which strikes about 750,000 patients a year in the United States and is associated with significant treatment costs, is a model condition for determining whether there is a link between hospital spending and patient outcomes, according to the study.

"The mortality rate of patients with sepsis approaches 20 percent and the annual costs attributable to sepsis care have been estimated at $17 billion, similar in magnitude to the costs of ischemic heart disease," wrote the authors, led by Dr. Tara Lagu of Baystate Medical Center in Springfield, Mass.

The researchers evaluated data from 309 hospitals nationwide that treated at least 100 patients with sepsis between June 2004 and June 2006. The hospitals also participated in the Perspective database, a voluntary database created to measure hospital quality and health care utilization. Most (84 percent) of the participating hospitals were in urban areas.

Information from 166,931 patients with sepsis was included in the study. The average age of patients was 70 years old, with 52 percent women and 62 percent white. Many of the patients also had chronic health conditions, such as hypertension (35 percent), diabetes (33 percent) and chronic anemia (31 percent).

While hospitalized, 33,192 patients (20 percent) died. The expected mortality rate for all hospitals was 19.2 percent. Of the hospitals with expected mortality between 18.5 and 19.5 percent, the actual mortality rates ranged from 9.2 to 32.3 percent. There were 66 hospitals (21 percent) that had mortality rates significantly higher than expected -- 20 had mortality rates between 10 percent and 25 percent higher, and 46 hospitals' rates were 25 percent higher than expected.

The average hospital cost was $18,256 for each patient. Thirty-four percent of the hospitals spent more than the expected costs of $18,659 by at least 10 percent, with an average excess cost per patient of $5,207.

The authors also divided the 309 hospitals into five separate quintiles based on the average cost spent per patient -- with the lowest-spending hospitals in quintile 1 and the highest-spending hospitals in quintile 5. While they found the differences in patient mortality outcomes by quintile were initially significant, once they removed quintile 5 with the highest-spending hospitals, the differences between the lowest- and highest-spending hospitals were insignificant. The authors revealed similar results when dividing hospitals by both size (number of beds) and teaching status.

The researchers therefore concluded that there was no significant link between the hospitals' spending and mortality rates among the sepsis patients.

"Hospital spending and mortality rates for patients with sepsis vary substantially, but higher hospital expenditures are not associated with better survival," wrote Lagu and her fellow researchers. "Efforts to enhance the value of sepsis care could be modeled on hospitals that achieve lower-than-expected mortality and cost."

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